What is your work experience and basic principles/ideas related to stroke physiotherapy?

I am currently in my final year of my physiotherapy degree. As part of this degree process, I have so far completed 3 clinical placements (out of 4) and I am doing the last one at the present time. These placements had occurred within public settings.

About the background of my stroke physiotherapy practice, my first internship was in the acute stroke unit in the hospital of Gaia in Porto in Portugal. The clientele predominantly involved ischemic stroke, hemorrhagic stroke and venous thrombosis. Rehabilitation with these clients occurred few days after the accident.

From my experience, physiotherapy associated with stroke patients varied considerably about the area cerebral lesion and is dependent on a number of common factors. I believe the most influencing factors include the frequency, the intensity of the treatment and, furthermore, the time past before started the rehabilitation after the accident onset and the previous level of physical abilities.

I used mostly the Bobath therapy which has the aim to normalize the tonus, the movement and the function of the patient. Bobath concept is basing on the control of the movement due to the neurologic and muscle skeletal intact system and the postural control which permit to have good movement of the trunk and limbs. So, in case of a patient, the adaptation of the structural brain alteration is going to be modify by the afferent input of the neurologic system and it will adapt the sensorimotor behavior into modify the normal movement pattern into an efficient movement pattern.

From the acute stage, physiotherapy can involve addressing range of movement (ROM) maintenance, positioning (to prevent contracture and eschar) and respiratory function. Following the stage, physiotherapy can encompass a large number of modalities including but not limited to: bed mobility (rotation), transfers (bed-chair/chair-bed), upper and lower limb rehabilitation (Bobath concept, PNF, manual active/passive movement), sit to stand, walk, stairs, activities of daily living, mirror therapy, CIMT constraint therapy, motor imagination, PANat concept etc.