Neurological & Stroke Rehabilitation

Conditions this covers

• Stroke — both weakness affecting one side of the body and the balance, coordination and walking problems that follow.
• Post-traumatic brain injury movement and balance rehabilitation.
• Spinal cord injury rehabilitation, including transfer training and wheelchair-level mobility.
• Parkinson’s disease — gait, balance, freezing and posture work.
• Facial palsy, including Bell’s palsy, with facial muscle retraining.
• Peripheral nerve injuries affecting movement in an arm or leg.
• Balance and dizziness problems of neurological origin.

How neurological rehabilitation is structured

Assessment establishes a baseline: muscle tone, voluntary control, sensation, balance in sitting and standing, and how much assistance each functional task currently needs. That baseline matters, because progress in neurological rehabilitation is often gradual and is easy to underestimate without measurement.

Treatment is then built around task-specific practice. If the goal is standing up from a chair independently, the treatment involves practising that transfer with the right amount of assistance, reducing assistance as control improves, rather than only exercising the muscles in isolation. Strength work, tone management, stretching to protect joint range, and balance retraining all support that functional goal.

Repetition volume matters in neurological recovery. Part of the physiotherapist’s job is making sure the practice continues between sessions, which is why family training is built into the programme rather than treated as an afterthought.

Training for families and carers

In Bangladesh most stroke care after discharge happens at home, delivered by family members who were given very little instruction. Handled well, that is a genuine advantage — the patient gets far more practice than any clinic schedule could provide. Handled badly, it leads to painful shoulders, falls, and carers with back injuries.

We teach the people doing the daily care how to help safely: how to assist a transfer without pulling on a weak shoulder, how to position limbs to protect joint range, how to support walking practice, and which exercises to repeat during the day. Attend a session with the patient and ask to be shown directly.

Timing and expectations

Rehabilitation generally starts as soon as the patient is medically stable — earlier involvement gives better opportunity to prevent secondary problems such as joint contracture, shoulder pain and deconditioning. Recovery is usually fastest in the first months and then continues more gradually, and meaningful functional gains can still be achieved later, particularly in balance, walking quality and confidence.

We will not tell you that a specific level of recovery is guaranteed, because that depends on the injury and varies between individuals. What we will do is measure where you are, set the next achievable goal, and be straightforward about progress.