Online physiotherapy for stroke recovery
If you are medically stable after leaving hospital, a video session lets your physiotherapist watch how you move and set up practice for walking, balance and everyday tasks, with a carer welcome to join. Before you start, your GP or specialist team must confirm it is safe for you to begin physiotherapy. Face drooping, arm weakness or slurred speech means 999.
How online physiotherapy works for stroke recovery
Our neurological rehabilitation service is for people who are medically stable and whose hospital care has been arranged. It does not replace your NHS stroke team or your GP. Before you start, your GP or specialist team must confirm it is safe for you to begin physiotherapy. Our service guidance says online sessions are for guided, ongoing practice once you are stable, and that any new or sudden symptoms are an emergency, not an appointment.
The NHS says a stroke rehabilitation plan may include physiotherapy and exercises to help with movement, and that recovery can take months or years. It also says rehabilitation can be done in person or online, which it calls telerehabilitation, and that your healthcare team should provide equipment and training or technical support if you need them.
NICE guidance on stroke rehabilitation in adults (NG236) says telerehabilitation can be considered instead of, or as well as, face-to-face therapy, but only if the person agrees or it is their preferred type of therapy and it fits their rehabilitation goals. It also says people should have the right equipment and training or support, and should be monitored to check that they are benefiting and are not developing signs of depression. NICE does not endorse our service. We mention the guidance because those conditions are the ones we try to meet.
In practice we start by asking which everyday activities matter most to you, for example getting around outside, using stairs or using your arm at home. Our service guidance says early movement checks over video are done seated or with support, and that a family member or carer can join you and help get the room ready.
Video has limits. We cannot touch the affected limb or catch you if you lose your balance, so we choose movements that can be done safely at home with something solid nearby and, where needed, another person in the room. If a task does not look safe on video, we will say so and suggest in-person therapy through your NHS team instead.
What the video assessment checks
- Confirmation that your GP or specialist team has said it is safe for you to begin physiotherapy, your stroke history in your own words, and what your discharge letter said about exercise.
- Whether you feel well enough to take part now, and whether your doctors have said anything about activity or driving.
- How you move around your home: getting out of a chair, walking, using stairs, and which aids you use.
- Balance and strength in the arm and leg, checked through simple movements done seated or with support.
- Who can be with you during the session, such as a family member or carer, and whether your camera and room set-up are safe for the movements we plan.
- Your mood, tiredness and confidence, because NICE says people doing telerehabilitation should be monitored for signs of depression, and we will suggest you speak to your GP or stroke team if you are struggling.
What treatment usually involves
Your plan is built around goals you choose, for example getting around more easily or using your arm more in daily life. We turn them into a short routine you can repeat at home, usually seated or supported at first, and we change it as you progress.
The first session is a 60-minute video assessment at £40, and follow-ups are 30 minutes at £30. Triage at booking confirms whether video suits you, and we will tell you before you pay if it does not.
Our service guidance says a carer can help you keep practising in between sessions. In our approach, we do not give a fixed timeline, because stroke recovery looks different for each person we see. We review progress against the things you wanted to do again.
Keep your GP or specialist team informed about your treatment. The NHS says a review of your progress should happen after about 6 months, and we do not replace that review. NICE guidance on stroke rehabilitation recommends physiotherapy for people with weakness, changes in feeling or balance problems that affect movement after a stroke.
How long recovery usually takes
The NHS says stroke recovery can take months or years, so we do not promise a date. Our service guidance says reviews look at things you can feel, such as walking further or needing less support, rather than a fixed timeline. We review these with you and your carer at each session.
When you need to be seen in person instead
A video appointment is not the right route for the situations below, and a home visit is not a substitute for urgent care.
- Call 999 now if you think you or someone with you is having a stroke. Use FAST: Face drooping, Arm weakness, Speech difficulty, and Time to call 999. Other signs include weakness or numbness down one side, blurred vision or loss of sight, and dizziness. Do not drive yourself to A&E.
- A stroke needs urgent medical help in hospital. A sudden new symptom is not something to raise at a physio session.
- If you have severe hip pain after a fall or injury, cannot walk or put weight on the leg, or have tingling or loss of feeling in the hip or leg after a fall or injury, the NHS says to call 999 or go to A&E. Do not drive yourself.
- After a head injury, such as in a fall, the NHS says to call 999 if, for example, the person has been knocked out and has not woken up, cannot stay awake, has a seizure, has fallen from a height of more than 1 metre or 5 stairs, has problems with their vision or hearing, has clear fluid coming from their ears or nose, has new numbness or weakness, has problems with walking, balance, understanding, speaking or writing, or their behaviour has changed. This is not the full list, so see the NHS head injury page listed in the sources. If you take blood thinners, are being sick or feel dizzy after a head injury, contact NHS 111. Do not drive yourself to A&E.
- Any sudden or new change in your speech, such as slurred or lost words, goes to the 999 line above and does not wait for a session. For worries that are not an emergency, such as new low mood, ongoing swallowing or speech difficulties you already have, or a plan that no longer feels right, contact your stroke team or GP. Online sessions are not for acute care.
- If you need hands-on therapy or equipment set up in person, we cannot provide that by video. Triage at booking tells you honestly if video does not suit you.
Common questions
Can I have online physiotherapy after a stroke?
If you are medically stable and your hospital care has been arranged, it may suit you. The NHS says stroke rehabilitation can be done in person or online. Triage at booking confirms whether video suits you, and a carer is welcome to join.
Does this replace my NHS stroke team?
No. We are a separate private service and we do not replace your NHS stroke team or any other therapists. Keep your GP or specialist team informed about your treatment.
Do I need anyone's go-ahead before I start?
Yes. Before you start, your GP or specialist team must confirm it is safe for you to begin physiotherapy. We ask about this at booking, and triage confirms whether video suits you.
Can my carer or family come to the session?
Yes. Our service guidance says a family member or carer can join, help get the room ready and help you keep practising in between sessions.
What should I do if I think I am having another stroke?
Call 999 straight away and do not drive yourself. Face drooping, arm weakness and speech difficulty are signs to act on at once.
Further reading
This information is general and not a substitute for an assessment. Don't start a new exercise programme without advice from a physiotherapist or doctor who knows your condition. If an exercise causes pain that doesn't settle, stop and seek advice.
Sources
Book an online assessment
A 60-minute video assessment with an HCPC-registered physiotherapist is £40.
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