How should I manage a patient with a recent stroke in terms of physiotherapy referral and rehabilitation?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Physiotherapy referral and rehabilitation management for a patient with a recent stroke should include:

  • Referral to a specialist stroke service, ideally a stroke unit or specialist stroke team in the community, to ensure access to multidisciplinary stroke rehabilitation expertise including physiotherapists trained in stroke care .
  • Provision of physiotherapy for patients with weakness, sensory disturbance, or balance difficulties affecting movement, delivered by physiotherapists with relevant skills in diagnosis, assessment, and management of post-stroke movement problems .
  • Continuation of physiotherapy until the patient can maintain or progress function independently or with assistance from others such as carers or rehabilitation assistants .
  • Consideration of strength training for muscle weakness, including progressive resistance exercises such as sit-to-stand repetitions, weights, or resistance machines .
  • Encouragement and facilitation of physical activity and fitness training, including cardiorespiratory and resistance training tailored to the patient’s goals and started under physiotherapist supervision .
  • Provision of information and support for ongoing independent exercise programmes, ensuring safety and adaptation to the patient’s needs, possibly involving communication with exercise providers .
  • Assessment and management should be part of a coordinated multidisciplinary approach involving other professionals such as occupational therapists, speech and language therapists, and social workers to address comprehensive rehabilitation needs .

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