Physiotherapy after stroke

Daniel Smit | Physiotherapist

Supporting movement, function and participation after a stroke

The focus of rehabilitation is what matters to you: practising movement and everyday tasks in a way that is individualised, progressive and safe.

What happens in a stroke?

A stroke occurs when the blood supply to part of the brain is interrupted, usually by a blocked blood vessel or bleeding. The affected area can no longer work as it usually does. Because different parts of the brain control movement, sensation, vision, communication and thinking, the effects depend on where and how much the brain is affected.

Common effects can include weakness or reduced control on one side, difficulty coordinating movement, changes in sensation or muscle stiffness, and problems with sitting balance, standing or walking. Fatigue, pain, reduced confidence and changes in vision, communication, memory or mood can also affect daily activities. Some changes are less visible but still have a major impact. Every person’s combination of effects is different.

Recovery is individual

A stroke can affect movement, balance, coordination, sensation, strength, endurance and the ability to manage everyday activities. The effects differ from person to person, and they can change over time. Rehabilitation is guided by the person’s goals, abilities, health and preferences.

Physiotherapy may begin in hospital when the treating team considers it safe, then continue in inpatient rehabilitation, at home, in an outpatient clinic or through a combination of services. A plan can also be reviewed later if needs or goals change.

How physiotherapy can help

A physiotherapist assesses how the stroke is affecting movement and daily life, then works with the person to set practical goals. Depending on individual needs, physiotherapy may focus on:

An assessment looks at the activities you want or need to do and what may be making them difficult. Depending on your needs, this can include movement and strength on both sides, balance in sitting and standing, transfers, walking, coordination, sensation, muscle stiffness, pain, fatigue and activity tolerance. Your physiotherapist may also ask about falls, daily routines, mobility aids, home access and the support available to you.

This information helps shape a plan around your priorities and current abilities. Progress is reviewed over time, and goals or supports can be adjusted as your needs change. A physiotherapy assessment is not just a test of strength; it considers how movement works in real activities and environments.

Walking, transfers and bed mobility; balance and confidence with everyday movement; strength, coordination and control of the affected arm or leg; fitness and activity tolerance; posture, flexibility and comfort; and practising tasks that matter to the person, such as standing from a chair, managing steps or walking outdoors.

Rehabilitation is not limited to the first weeks or months. People may continue to make gains or benefit from support at different stages after stroke. Progress is individual and cannot be predicted from one person’s experience.

What sessions may involve

Sessions are guided by assessment and shared goals. They may include repeated practice of meaningful tasks, walking and balance activities, progressive strengthening, aerobic exercise when appropriate, and strategies to make movement safer and easier in daily routines. Practice might include repeated sit-to-stands, a transfer, stepping or walking a route that matters in your day.

The physiotherapist adjusts the challenge, support, equipment and rest to your capacity. Fatigue, falls risk, pain, other health conditions, communication or cognitive changes, and your home environment can affect how practice is planned. The plan can be reviewed if your function or health changes.

Where it is suitable, practice between appointments can provide extra opportunities to work towards goals. A home program should be clear, manageable and safe, with an agreed plan for how much to practise and when to pause or seek advice.

Working with the wider team

Stroke rehabilitation is often multidisciplinary. Physiotherapists may coordinate with the person’s GP, rehabilitation physician, occupational therapist, speech pathologist, nurse, psychologist and other members of the care team. Occupational therapists can help with daily activities and equipment; speech pathologists can support communication and swallowing; and the medical team can advise on health issues that affect exercise and recovery.

Family members and support people can be involved with the person’s consent. Useful support can include helping communicate goals, making the home practice safer, and sharing observations about what is changing.

When to seek help

Call 000 immediately if new or sudden symptoms suggest another stroke, even if they improve. Use FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 000. Do not wait for a physiotherapy appointment.

Contact the treating doctor or physiotherapist if there is a new fall, increasing pain, a noticeable change in movement, worsening fatigue, or a concern that current exercises or mobility supports are no longer safe.

Physiotherapy at Strides Health Group

Our adult physiotherapy service can support people after stroke with an individual assessment and a practical plan for movement, mobility and everyday goals. We will consider the person’s current abilities, priorities, health and existing rehabilitation supports, and communicate with other treating practitioners when appropriate.

Contact us to discuss whether our service is suitable and how appointments can be arranged. Strides Health Group is based at 426 Princes Hwy, Narre Warren VIC 3805. Call 0411 876 851 or email admin@strideshealth.com.au.

Download the physiotherapy after stroke handout (PDF)

References and further information

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