Typically, rehabilitation efforts begin within 24 to 48 hours following a stroke. This usually occurs in an acute-care hospital. Patients are asked to change positions frequently while in bed and to perform basic range-of-motion exercises. These may help stimulate and strengthen limbs damaged by the stroke. Over time, patients may be encouraged to sit up and to move from the bed to a chair. Once patients have begun to walk, they may progress to more complicated tasks, such as bathing, dressing and using a toilet.

Once patients are discharged from the hospital, they either return home or enter a type of inpatient medical facility, depending on the severity of impairment. In general, physicians try to encourage individuals to participate in the most rigorous rehabilitation program that they can handle. This is usually determined by taking into account the patient’s age, degree of disability and overall health.

Patients who are able to return home may attend rehabilitation sessions at an outpatient facility, which is often attached to a larger hospital complex. Patients usually attend these sessions a few times each week for several hours per session. Nursing facilities also may offer outpatient rehabilitation, although such services may be offered for fewer hours than at other outpatient centers.

Home-based rehabilitation is available for many patients, and is especially useful for those without access to transportation or who require treatment from just one type of rehabilitation therapist. Home-based rehabilitation may not be an option for patients who need access to specialized rehabilitation equipment.

Patients with severe impairments may not be able to return home immediately. Instead, they will enter inpatient rehabilitation units, where they may stay for two to three weeks. Therapy sessions may last for three hours and may be scheduled for up to five or six days each week. At the end of this time, patients may be able to return home or they may be admitted to a long-term care facility. About 10 percent of stroke survivors require care in a nursing home or other long-term care facility, according to the National Institutes of Health.

Most patients are involved in rehabilitation programs for several months following their stroke. However, the time required for rehabilitation differs depending on the severity of the patient’s brain damage and which functions are affected. 

Rehabilitation may take many forms, depending on the nature and extent of the patient’s impairments. For example, physical therapists and occupational therapists design repetitive exercise plans for patients, which are aimed to improve the patient’s basic ability to move and function. This many include using a treadmill to help a patient relearn to walk. Physical therapy may also involve helping a patient learn how to use a wheelchair or other assistive device. Physical therapists can assist patients in dealing with fatigue, which is common after stroke. The patient can be taught methods to move more efficiently, conserve energy, and gradually build physical stamina to combat fatigue.

For patients with aphasia or other problems with speech or language, speech therapy may be recommended. During this type of therapy, patients may be given exercises to improve the muscles necessary for speech and swallowing. Patients may also be shown ways to circumvent their speech problems by using alternate forms of communication.