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 NICE NG236.
- 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 NICE NG236.
- Continuation of physiotherapy until the patient can maintain or progress function independently or with assistance from others such as carers or rehabilitation assistants NICE NG236.
- Consideration of strength training for muscle weakness, including progressive resistance exercises such as sit-to-stand repetitions, weights, or resistance machines NICE NG236.
- 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 NICE NG236.
- 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 NICE NG236.
- 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 NICE NG236.