If you have one-sided paralysis or weakness, correct positioning is important to prevent spasm or injury. If you are unable to move, you will need a special mattress and the nurses may need to move you at regular intervals (usually every two hours) to prevent bed sores.

If you are unable to move, you may be given chest physiotherapy to keep your lungs free of infection. If possible, you should be helped to sit up, as this will help avoid blood clots in your legs, improve your breathing and help your recovery.

You may be moved out of the stroke unit to a different ward or rehabilitation unit to continue your treatment. In some places a specialist community rehabilitation team will support you to continue your recovery at home.

While you are in hospital, the physiotherapist will help the stroke nurses set up your plan of care to keep you as well as possible and avoid any complications that might slow down your recovery.

They will advise on how you should be positioned when lying or sitting, and how often you need to be moved. They can help you decide when you should begin to get up out of bed and start walking and what equipment (if any) is needed to move or support you.

The therapist should work together with the rehabilitation team, and your carer, family or friends to support your recovery in a coordinated way. They can support you, your family and any carers how you can do as much as possible for yourself and move around as much as possible.

Moving again after weakness or paralysis

If you have serious weakness or paralysis down one side, and you are medically stable, your physiotherapist will use more active therapy to teach you how to do the things you are having difficulty with and get your limbs moving again.

Once you are medically stable, the aim will be to get you moving as soon as possible. This will include moving around your bed, then from bed to chair, sitting to standing, walking with and without support and finally climbing stairs. This is likely to be a gradual process, and it is important to get each step right, so that you will end up with a balanced way of moving.

It is more difficult to sit up safely in bed than in a chair, so you may soon find yourself sitting in a suitable bedside chair with your affected side supported by pillows. This will help re-establish your balance and a sense of your mid-line (the imaginary line that divides your body into left and right sides).

When you are ready, the therapist will get you onto your feet using a hoist or two or three extra helpers. This will give you a chance to support your own weight and encourage you to use the muscles of your trunk, hips and legs. Your therapist may not encourage you to walk straight away if you need time to recover your strength and flexibility.

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