- Session
- 60–90 minutes
- Family
- Trained too
- Focus
- Real tasks, not machines
More and earlier is not automatically better
This is the part that most often surprises families. A large trial called AVERT compared very early, high-dose mobilisation — starting within 24 hours of the stroke — against usual care, and found the odds of a favorable outcome at three months were actually *lower* in the high-dose group.
Follow-up analysis of the same data points in a more promising direction: shorter but more frequent sessions in the early period were associated with better outcomes than long, tiring ones.
In the therapy room, that means we manage the dose, watch for fatigue, and do not chase minutes for their own sake. A family's instinct to "do as much as possible" is completely understandable — it is just not what the evidence shows.
The training that counts is a real task
Standing up from a chair. Moving from bed to wheelchair unaided. Lifting a glass. Stepping on uneven ground. We build the program around the tasks you actually want back, and repeat them a lot — meaningful repetition is the fuel of recovery after stroke.
The family is trained too, not left waiting outside. How to transfer someone safely, how to give just enough help without taking over, and which struggles to leave alone because the struggle *is* the training. This is the part that decides most of what happens at home.
Frequently asked questions
It has been two years since the stroke. Can there still be progress?
Recovery is fastest in the first months, but that does not mean the door closes afterwards. Walking, balance and day-to-day independence can still change with training that is well targeted and repeated enough. We will be honest at the end of the assessment about what is realistic — and what is not.
Do we need special equipment at home?
Far less often than people expect. A stable chair, room to walk, and a grab rail in the bathroom are usually more useful than expensive equipment. We work out what is genuinely needed for your situation and your home — and name the things you do not need to buy.
How often should sessions be?
It depends on the stage and on stamina, and that is decided after the assessment — not sold as a package upfront. What matters more than the number of clinic sessions is what happens between them. That is why every visit ends with a home program the family can run.
Sources
The figures and recommendations on this page come from the sources below. The links go to third-party sites.
- AVERT Trial Collaboration — Efficacy and safety of very early mobilisation within 24 h of stroke onset, The Lancet (2015)
- Bernhardt et al. — Prespecified dose-response analysis for A Very Early Rehabilitation Trial (AVERT), Neurology
This page is educational and does not replace an examination by a doctor. If your child is unwell, or something does not feel right to you, have them seen first.