Physio reducing sessions

by Keith Podmore
(Manchester UK)

Question: My physio has told me my sessions are going down to 1 session per week now I'm home...I still cannot walk and I'm wheelchair-bound due to a stroke on my right side. She said it's because my progress has come to a standstill and I no longer seem to be improving, I came out of the hospital in December and we are in May. Surely this isn't long enough for a treatment plan to help me walk again? Any idea what I can do to access more therapy that won't cost me a fortune?
Many thanks.

Answer: I would suggest calling the UK Stroke Helpline at 0303 3033 100 or email helpline@stroke.org.uk and ask them what treatment options are available. It is not unusual for therapy visits to taper off. I don't know the protocols in the UK since I am in the US, but here patients often go to outpatient facilities and get more treatment after having home therapy. In addition, even if therapy tapers off or stops, you can ask for more treatment later especially if there are any changes (i.e. decline or improvement, changes in spasticity/tone, other illness leading to debility, changes in caregiver).

Many stroke patients are in and out of therapy in their years post-stroke, so if your therapist ends therapy sooner than you'd like, you could wait 6-9 months and ask for therapy services again in the future. I have found that tone/spasticity often changes in this first year, so that could be the reason for a new request if you have that issue. There are other reasons to justify therapy such as pain, weakness on the non-affected side, overuse issues on the non-affected side, a fall or falls, changes in living situation, effects of medication, etc. Sometimes you have to think about symptoms/problems other than the stroke itself when requesting therapy in the future. This is especially true if you are getting pushback from your therapists or MD for prescribing more therapy for the stroke.