Strokes can cause weakness or paralysis in one side of the body. Many people also have problems with co-ordination and balance, and suffer from extreme tiredness (fatigue) in the first few weeks after a stroke. They may also have difficulty sleeping, making them even more tired.

As part of your rehabilitation you should be seen by a physiotherapist who will assess the extent of any physical disability before drawing up a treatment plan.

Physiotherapy will normally begin as soon as your medical condition has stabilised. At first, your physiotherapist will work with you by setting goals to improve your posture and balance. As your condition improves, more demanding long-term goals, such as standing or walking, will be set.

A careworker or carer, such as a member of your family, will be encouraged to become involved in your physiotherapy. The physiotherapist can teach you both simple exercises you can carry out at home.

Physiotherapy can sometimes last months or even years.

The specific abilities that will be lost or affected by a stroke depend on the extent of the brain damage and, most importantly, where in the brain the stroke occurred: the right hemisphere (or half), the left hemisphere, the cerebellum or the brain stem. The Stroke Foundation provides a directory for assistance in managing these common issues at strokefoundation.com.au.

The most common problems in daily life are likely to be caused by:

• weakness or lack of movement (paralysis) in legs or arms
• shoulder pain
• trouble swallowing
• changes to way things are seen or felt (perceptual problems)
• changes to the way things are felt when touched (sensory problems)
• problems thinking or remembering (cognitive problems)
• trouble speaking, reading or writing
• incontinence
• feeling depressed
• problems controlling feelings
• tiredness.

If you are experiencing anxiety or depression, you should also speak to your doctor.

The team involved in the rehabilitation program will help you and your carer to learn the skills you need to manage your daily life after a stroke.

A carer can provide physical, practical or emotional help to someone after their stroke. And it is beneficial for carers to recieve training to enable full participation, where necessary, in assisting communication between you and other care providers and services, such as support groups or Centrelink. The training will also assist with their involvement in:

• talking to health professionals about assessments and test results
• helping to set goals and being involved in treatment decisions
• joining in with therapy sessions
• encouraging you to practise exercises and activities suggested by the therapists
• helping to celebrate progress
• using a communication book to help them remember things. This can be things like who has visited, which therapists they have seen, what they said, and exercises to practice.

Carers can call StrokeLine to talk to a health professional for free information and advice: 1800 STROKE (787 653).

Some aspects of life to be managed after a stroke

Resuming work

How soon this is possible depends partly on remaining disability, the type of work involved and the feelings about returning to work. Some people feel quite tired after a stroke, and have difficulty carrying out any kind of physical activity for any length of time. Part-time work, at least in the early stages, may be a good idea. Unless the stroke has reduced awareness of impairment, it is probable that the person who had the stroke is the best judge of when to return to work or getting back to the regular activities in your life. 

Driving

Even someone who appears to have made a full recovery after a stroke should not drive a car for at least a month as the risk of another stroke is greatest at this time. To drive again involves being cleared by your doctor, who will be aware of relevant government regulations. The stroke may have left subtle impairments, not always apparent, such as poor co-ordination, lack of awareness on one side, difficulties in judging distance, changes in vision, difficulties in concentration and confusion between left and right.

Sexual activity

Resuming of sexual activity after a stroke is encouraged. Most couples experience some difficulty in their sex life after a stroke, but this is usually due to psychological factors rather than any disability caused by a stroke.  A doctor can advise on how to get help for psychological problems and other difficulties such as erectile problems in men.

Sport and exercise

Physical activity and hobbies are important parts is an important part of rehabilitation - normal activity should be resumed as soon as physically possible.

Drinking alcohol

The intake of excessive amounts of alcohol should be avoided after a stroke as it may interact adversely with medication, raise blood pressure and affect judgement resulting in injury. Moderate consumption (two standard drinks per day) should not cause any problem.

Sources: Brain Foundation (Stroke), NHS Choices, UK (Stroke - Recovery)