Physical Therapy After a Stroke

After a stroke, muscles may not remember how to perform actions that were once simple, like sitting and walking. A stroke patient will need to relearn these skills with the help of physical therapy. Physical therapy retrains muscles and reminds them how to work together again.

Physical Therapy: Regaining Mobility

Physical therapy focuses on getting the stroke patient to use limbs that have been weakened or paralyzed by the stroke.

While occupational therapy concentrates on helping patients learn to feed themselves, chew and swallow, and get dressed, the main goal of physical therapy is mobility. A physical therapist wants to teach the stroke patient how to walk, sit, stand, and get in and out of bed, a chair, and a car all on their own.

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"Physical therapists evaluate and treat the deficits that stroke patients are left with, the musculoskeletal deficits. We will start in acute care, with early mobilization of the patient and exercises," says Mary Ann Owsley, PT, supervisor of the physical therapy stroke team for inpatient rehab at the Frazier Rehab Institute, a service of Jewish Hospital and St. Mary's HealthCare in Louisville, Ky.

"We get them up and moving around as soon as possible, even if all they are able to do initially is sit up on the side of the bed and work on sitting balance. Then we progress to being more independent with all of their basic mobility — from getting in and out of the bed to the wheelchair, to walking with different types of assistive devices, like canes and walkers," says Owsley.

Physical Therapy: Success Through Strength

Physical therapy involves using and strengthening the muscles, even before the patient can do this on their own. Therapists use both active and passive range-of-motion and strengthening exercises. Active exercises are ones the patient performs unassisted; passive exercises are performed or aided by the physical therapist. Both types help strengthen muscles.

The physical therapist will create an exercise program for the patient to follow so that muscle strength can be maintained and new skills won't be lost.

Physical Therapy: Family Education

Physical therapy also involves working with family members and caregivers. "We start working with the families as soon as we can to follow through with any of these techniques for positioning and range of motion," says Owsley. "We do a lot of education with the stroke victim and their families as far as the limitations that they may be left with."

Physical Therapy: Following Through With a Plan

Physical therapy often starts while the stroke patient is still in the hospital, so you can continue to work with the same physical therapist once you return home or move to the inpatient stroke rehab center. However, if your initial treatment was not at a primary stroke center with health providers specifically trained in stroke, you may want to find a physical therapist to help with your stroke recovery at a certified stroke rehabilitation center.

Physical Therapy: Managing the Costs

Often, private health insurance plans will cover either a percentage of the costs or a set number of physical therapy sessions. Medicare usually pays for physical therapy after a stroke. Find out about your coverage before physical therapy begins so you understand what costs, if any, you will be responsible for.

Physical therapy works best when it is started early and is continued regularly, usually a few times each week. Slowly but surely, your body will start to remember and respond, and repair the damage done by stroke.

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