In this guide
After a stroke, many patients come home with weakness on one side of the body and difficulty walking or keeping their balance. Physiotherapy helps recover what can be recovered and regain as much independence as possible. Doing it at home avoids journeys that are often hard at this stage, and lets the physio work in the patient’s real surroundings: their bed, their stairs, their bathroom.
Why start early?
After a stroke, the brain can partly reorganise itself, and progress is often fastest in the first weeks and months. This is why rehabilitation usually starts as soon as the patient’s condition allows, often while still in hospital.
Progress doesn’t stop after a few months, though: with regular work, many patients keep gaining strength, balance and confidence for a long time. It is never too late to start.
Rehabilitation is prescribed by a doctor (neurologist, family doctor or rehabilitation physician), who also sets the number of sessions.
What the physio does in the sessions
The physio starts with an assessment: what the patient can do alone, their strength, balance, walking and pain. They then set concrete goals with the patient and family, such as getting out of bed alone or walking to the door. They may:
- move the joints on the affected side and keep the muscles supple, to limit stiffness;
- strengthen the muscles of the legs, trunk and arm, on both sides;
- work on balance, sitting then standing, to reduce the risk of falls;
- relearn transfers: from bed to chair, standing up from a chair, getting to the toilet safely;
- get walking again, with or without an aid (cane, walker), then stairs;
- stimulate the affected arm and hand in everyday tasks;
- show the family the right positions and the exercises to do between sessions.
Depending on needs, other professionals may help: a speech therapist for speech and swallowing, an occupational therapist to adapt the home and daily tasks.
What a home session looks like
A session usually lasts between 30 minutes and an hour. The physio brings the small equipment they need. All it takes is a little clear space, a stable chair and, if possible, a relative present during the first sessions to learn the right moves.
The pace is set with the doctor and the physio: often several sessions a week at first, then further apart as the patient improves.
How the family can help
- Encourage the patient to use their affected side in simple tasks, without doing for them what they can do alone.
- Do the exercises the physio gives between sessions, a little every day rather than a lot once a week.
- Never pull on the affected arm to help the patient stand up or turn over: the shoulder is fragile after a stroke. Ask the physio how to help safely.
- Make the home safe: remove slippery rugs, clear the way, light it at night and, if possible, fit grab bars in the bathroom.
- Keep a routine: getting up, dressing and eating at the table, every day.
- Look after morale: tiredness and low mood are common after a stroke. Tell the doctor if they last.
Signs that mean calling for help
A new stroke is an emergency. If the face droops, an arm or leg suddenly becomes weak, speech becomes difficult or confused, or there is a sudden, unusual severe headache, call emergency services at once (15 or 141) and note the time the signs started. Don’t wait for the physio session.
Also tell the doctor quickly about new shoulder pain, a swollen, red or painful calf, or a fall.
Reimbursement
When prescribed by a doctor, physiotherapy can be covered by AMO (CNSS or CNOPS) or your insurer, depending on your cover. You need the prescription and a care sheet filled in by the physio. On Kinezy, physios who provide one say so on their profile.
This guide gives general information. It doesn’t replace the advice of your doctor or physio, who know your situation.