Janet came to us six months after suffering a left middle cerebral artery ischaemic stroke. She had been discharged from NHS inpatient rehabilitation after four weeks and had received a further six weeks of community physiotherapy before being discharged from that service too. Despite this, she remained significantly limited — she was walking short distances only with a stick, had very limited use of her right arm and hand, and had stopped driving, cooking, and socialising. Her family were concerned and felt she had plateaued far too early.

Assessment

On initial assessment, Caitlin identified significant residual weakness in Janet’s right upper and lower limb, moderate spasticity at the elbow and wrist, impaired proprioception in the right foot, and reduced dynamic balance. Janet’s walking speed was well below the community ambulation threshold. Her primary goals were to regain enough arm function to cook independently and to walk to her local shops without fear of falling.

Treatment

Caitlin delivered a 16-week home-based rehabilitation programme, visiting twice weekly. Treatment combined task-specific upper limb training targeting reach, grasp, and release with progressive gait retraining and balance work. Mirror therapy was incorporated in the first eight weeks to support upper limb recovery. Environmental modifications were made to the kitchen to enable safer independent cooking practice between sessions.

Outcome

By week 12, Janet had exceeded her goal of independent cooking — she was preparing full meals for her family. By week 16, her walking speed had improved to above the community ambulation threshold and she was walking to her local shops independently. She returned to driving at month eight following a formal driving assessment.

In Her Own Words

“I thought I had got as far as I was going to get. Caitlin showed me that wasn’t true. Within a few months I was doing things I genuinely thought I would never do again.”