Stroke rehabilitation · Physiotherapy, occupational therapy and speech therapy
Home stroke rehabilitation,
a home-visit team of physiotherapy, occupational therapy and speech therapy
A stroke often affects more than one hand or leg. The patient’s walking and movement, self-care in daily life, and even speaking and swallowing may all be affected. Our team of registered physiotherapists, occupational therapists and speech therapists visits the patient’s familiar home to carry out an assessment, and arranges suitable treatment according to actual needs.
- Hong Kong registered therapist team
- Home visits across Hong Kong
- PT / OT / ST working together
- Physiotherapy 1 hour $1,000, 1.5 hours $1,300
Understanding stroke rehabilitation
Common misunderstandings about stroke rehabilitation
The difficulties caused by a stroke are often many-sided. The patient’s mobility, self-care in daily life, communication and swallowing safety may all be affected at the same time. Full rehabilitation needs physiotherapy, occupational therapy and speech therapy to work together, with enough training at the right time to rebuild the patient’s ability to manage daily life.
- The earlier the push, the betterBelieving that high-intensity, high-volume training straight after a stroke is best
- Strength aloneBelieving that once the arms and legs are strong the patient has fully recovered
- One type of therapy is enoughBelieving that a single therapist can deal with all the problems after a stroke
- Well timed, enough and continuingTraining once the condition is stable, using the period when the brain’s neuroplasticity is strongest
- How much the patient can do back in daily lifeLimb movement, self-care, communication and swallowing each have their own assessment standards.
- Division of work between professionsPhysiotherapy covers limb movement, occupational therapy covers self-care, and speech therapy covers communication and swallowing.
There is a real early window for recovery. The first weeks to months after a stroke are when the brain’s neuroplasticity is strongest. However, starting early does not mean pushing hard with high-intensity training at the moment of onset. The large AVERT trial found that high-dose activity too early, within 24 hours of a stroke, led to a lower proportion of good recovery at 3 months (AVERT 2015). The key to rehabilitation is training that is enough in amount and fits daily needs, at the right time, once the condition is stable.
Our approach
How the work is divided in stroke rehabilitation
Physiotherapy (PT), occupational therapy (OT) and speech therapy (ST) each have a different role, and they follow the same principle: in the period when the brain’s neuroplasticity is stronger, provide enough training that fits daily needs to rebuild function. The three therapies can run at the same time according to the patient’s needs.
Physiotherapy (PT): training hand and leg movement, balance and walking
The physiotherapist helps the patient move step by step from lying in bed to walking again, with the focus on muscle strength, balance, gait and limb control. Exercises are designed in stages according to stroke severity (severe, moderate or mild) and the affected part (upper or lower limb), and retrain getting up, walking and transfers between bed and chair.
Occupational therapy (OT): rebuilding self-care in daily life (ADL)
Regaining strength in the arms and legs does not mean the patient can manage daily routines alone. Occupational therapy focuses on real daily activities and helps the patient practise dressing, eating and bathing again. It also provides cognitive training and home modification advice to reduce dependence on family members.
Speech therapy (ST): improving communication and swallowing safety
Aphasia is caused by damage to the brain networks that handle language, and it does not mean a problem with intelligence. Speech therapy addresses aphasia, unclear speech (dysarthria) and swallowing difficulty. Even when some time has passed since the stroke and the patient is in the chronic phase, training can still bring improvement.
Using the period of neuroplasticity: enough training that serves a practical purpose
Physiotherapy, occupational therapy and speech therapy follow the same principle of recovery. In the first weeks to months after a stroke, when the brain’s neuroplasticity is strongest, the programme provides enough repetitive practice that fits daily needs, so that the benefits of rehabilitation build up gradually.
Why train at home
Home training settings for stroke rehabilitation
We use the furniture and belongings the patient normally uses at home, and practise real movements in different corners of the home, so that the patient can more easily apply what is learned to daily life.
Training spots around the home TRIGGER MAP
Clinical evidence
Stroke rehabilitation: Hong Kong figures
Evidence and figures EVIDENCE
Rehabilitation training after a stroke matters a great deal, and the period of strong neuroplasticity does exist. However, progress and results differ from person to person. They build up gradually through enough, continuing training that targets the individual’s situation, and one or two sessions will not bring results. A therapist needs to assess each patient’s actual recovery according to their own condition.
If you are not sure which therapy the patient needs, or in what order to arrange them, contact us to talk it through and a therapist will answer your questions.
WhatsApp us free · instant quoteChoosing the right therapy for the patient
Three directions in stroke rehabilitation
A stroke can affect mobility, self-care, communication and swallowing at the same time, so rehabilitation usually needs therapists from different professions to work together. You can look at the three directions below first, and then open the page for each to read about the specific assessment and training.
FAQ · Fees and roles
Stroke rehabilitation FAQ
How soon after a stroke is it best to start rehabilitation?
Earlier and higher-dose is not always better. The large AVERT trial found that very early, high-dose mobilisation within 24 hours of stroke onset led to a lower proportion of good outcomes at three months. A better approach is to have a therapist assess the patient as soon as the condition is stable, and to use the weeks to months when neuroplasticity is strongest for enough repetitive and meaningful training. The most important point is to individualise the programme and avoid pushing every patient hard in the same way.
Which therapists are needed for stroke rehabilitation, and how do they divide the work?
A stroke often affects more than one area of function, so rehabilitation is usually carried out by a team of different professions. The physiotherapist (PT) works on physical mobility: muscle strength, balance, walking and limb control. The occupational therapist (OT) turns these abilities into self-care in daily life: dressing, eating, bathing, cognition and home modification. The speech therapist (ST) works on communication after stroke (aphasia and dysarthria) and swallowing problems. The three complement each other in stroke rehabilitation and can work together as needed.
What is the difference between home stroke rehabilitation and going to a hospital or clinic?
The biggest difference is the training environment. Home treatment lets the patient practise real movements using their own furniture and belongings, such as getting up from their own bed, walking along the corridor of their own home and using their own kitchen, so the benefit carries over more easily to daily life. The therapist can also identify and change hazardous areas of the home on the spot. Research shows that early supported discharge with follow-up at home by a multidisciplinary team can reduce the length of hospital stay and the risk of death or dependency.
Does rehabilitation need to continue at home after discharge?
Yes. Rehabilitation has only just begun. The weeks to months after a stroke are when the brain’s neuroplasticity is strongest, and enough continuing training is the key to regaining function. Even in the chronic phase, there is evidence that intensive training can still improve some functions, such as language. Continuing rehabilitation at home after discharge makes use of this period and lets progress turn directly into independent living.
How are home stroke rehabilitation fees calculated, and is there a minimum charge?
Physiotherapy costs HK$1,000 for 1 hour and HK$1,300 for 1.5 hours. There is no minimum charge, and a single session can be booked as needed. Fees for occupational therapy and speech therapy are available on enquiry. Travel is included in the main areas of Hong Kong Island, Kowloon and the New Territories, and remote areas may carry a $100–200 travel surcharge. You can WhatsApp 5473 6204 for a free enquiry and to book an assessment.
If you would like to know which therapy the patient needs, send us a message at any time.
WhatsApp us free · instant quotePhysiotherapy 1 hour $1,000 · 1.5 hours $1,300 · no minimum charge; OT / ST fees on enquiry · Fees for all services
Disclaimer: This article is general health information and is not professional medical advice. If you have any health concerns, please consult a qualified healthcare professional.
References
- Hong Kong SAR Government press release (2025). On World Stroke Day, the Department of Health urges the public to learn more about the warning signs of stroke and to adopt a healthy lifestyle (data on stroke as a leading cause of death in Hong Kong). Page in Chinese. info.gov.hk
- Li Ka Shing Faculty of Medicine, The University of Hong Kong (HKUMed) (2022). HKUMed study shows the incidence of “young stroke” in Hong Kong has risen by 30% (about 13,000–13,500 new stroke hospital admissions per year, and the rise in young stroke). HKUMed
- Kleim, J. A., & Jones, T. A. (2008). Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. Journal of Speech, Language, and Hearing Research, 51(1), S225–S239. PubMed
- Winstein, C. J., Stein, J., Arena, R., et al. (2016). Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 47(6), e98–e169. PubMed
- AVERT Trial Collaboration group (Bernhardt, J., et al.). (2015). Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet, 386(9988), 46–55. PubMed
- French, B., Thomas, L. H., Coupe, J., et al. (2016). Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic Reviews, (11), CD006073. PubMed
- Legg, L. A., Lewis, S. R., Schofield-Robinson, O. J., Drummond, A., & Langhorne, P. (2017). Occupational therapy for adults with problems in activities of daily living after stroke. Cochrane Database of Systematic Reviews, (7), CD003585. PubMed
- Breitenstein, C., Grewe, T., Flöel, A., et al. (2017). Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting. Lancet, 389(10078), 1528–1538. PubMed
- Langhorne, P., & Baylan, S. (2017). Early supported discharge services for people with acute stroke. Cochrane Database of Systematic Reviews, (7), CD000443. PubMed
- Anwer, S., & Alghadir, A. (2020). Incidence, Prevalence, and Risk Factors of Hemiplegic Shoulder Pain: A Systematic Review. International Journal of Environmental Research and Public Health, 17(14), 4962. PubMed
- Denissen, S., Staring, W., Kunkel, D., et al. (2019). Interventions for preventing falls in people after stroke. Cochrane Database of Systematic Reviews, (10), CD008728. PubMed
- Kwah, L. K., Harvey, L. A., Diong, J. H. L., & Herbert, R. D. (2012). Half of the adults who present to hospital with stroke develop at least one contracture within six months: an observational study. Journal of Physiotherapy, 58(1), 41–47. PubMed
- Hackett, M. L., & Pickles, K. (2014). Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. International Journal of Stroke, 9(8), 1017–1025. PubMed
- El Husseini, N., Katzan, I. L., Rost, N. S., et al. (2023). Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association. Stroke, 54(6), e272–e291. PubMed