- Home
- Can Physiotherapy Still Help a Year or More After a Stroke?
Can physiotherapy still help a year or more after a stroke?
Yes. Recovery is fastest in the first months, but it does not stop. Canadian stroke guidelines call for care that extends well beyond the first few months, and research on task-specific practice shows people can still gain function in the chronic phase. A year on, physiotherapy usually targets walking endurance, balance, arm use and the specific task you want back, and it builds the habits that keep gains.
Book An Appointment
Let’s Take the Next Step Together
The short answer
Many stroke survivors and families are told, or come to believe, that recovery ends at six months. The idea comes from the way early rehabilitation is organized: hospital and outpatient programs are time-limited, and the steepest part of recovery does happen in the first three to six months. But the end of a program is not the end of recovery.
The Canadian Stroke Best Practice Recommendations (7th edition, 2025 update) are built around the need for “coordinated and seamless systems of care that extend beyond the first few months following stroke” and on “building on progress achieved during the initial recovery stages.” In plain terms, the guidelines treat recovery as something that continues, and rehabilitation as something a person can return to when they have goals they want to work toward.
What changes after the first year is not whether physiotherapy can help, but what it works on and how.
What changes in late-stage rehabilitation
In the first months, some recovery happens on its own as the brain reorganizes, and therapy rides alongside it. A year later, spontaneous recovery has largely run its course and improvement depends on practice: doing the specific task, often, at a level that challenges you, and then carrying it into daily life. That is good news in one respect, because practice is something you control. It also means that a plan with no home program and no carry-over into your day will show little change, however good the sessions are.
What we work on a year or more after stroke
Walking distance and speed. Measured with the six-minute walk test and the 10-metre walk test. Community walking, crossing a road before the light changes, and keeping up with family are the usual goals.
Balance and fall risk. Measured with the Berg Balance Scale and the Timed Up and Go. Falls are the most common complication after stroke, and balance remains trainable years later.
The affected arm and hand. Measured with the Fugl-Meyer assessment or the Action Research Arm Test. Task-specific, high-repetition practice can improve arm use in the chronic phase; the assessment tells you what is realistic for your arm.
Fatigue and fitness. Post-stroke fatigue is common and under-treated. Graded aerobic exercise is part of most late-stage plans.
Getting back to a role. Driving, work, caring for grandchildren, a sport. The plan is built around the role, and the measures above are how we check it is getting closer.
What a realistic plan looks like
In our experience at Next Step, written as ranges: people in the chronic phase commonly attend weekly or more often, with a daily home program, for a block of several weeks, followed by a review and a decision together about whether to continue, pause, or move to a group or community program. Progress is checked against the goals you set at the first visit, with the same measures, so that you see change in numbers as well as in how things feel. Some people do several blocks over years with different goals; others do one block and then maintain on their own.
Group options, including our falls-prevention program, are useful for maintaining fitness and balance between or after individual blocks.
Who it is not for, honestly
Physiotherapy is not the right next step for everyone. If your main difficulties are with speech, swallowing or thinking, a speech-language pathologist is the right referral. If they are with dressing, cooking or managing at home, an occupational therapist is. If you have no specific goals right now and want to stay active, a community stroke recovery group or a supervised exercise program may serve you better than individual physiotherapy. We say so at the first visit, and we refer to the services we think fit. Our first-assessment page explains what that visit involves.
Stories from the clinic’s stroke community
Next Step hosts Coffee with Stroke Survivors, a series of conversations recorded with members of our stroke community about life and recovery long after the acute phase. One episode, 2 Strokes. 2 Daughters. Endless Courage, is a good place to start. Participants take part with their written consent. These are personal accounts, not treatment outcomes, and every stroke is different.
Cost and coverage
A neurological physiotherapy assessment is $150 and follow-up visits are $120; see the fee page. Alberta Health does not fund physiotherapy at private clinics in most cases; our Alberta Health coverage page explains the exceptions. Extended health benefits usually cover part of the cost and we direct-bill most insurers. Physiotherapy fees are an eligible medical expense for the federal medical expense tax credit.
To book, call (587) 855-4559 or use the online booking form. No referral is needed.
Clinically reviewed by Roopreet Kaur, Registered Physiotherapist, Next Step Physio & Neurorehab Clinic. Last reviewed October 2026.
FAQ
Timing
Is it too late to start physiotherapy two years after a stroke?
No. Canadian stroke guidelines call for care that extends beyond the first months after stroke, and task-specific practice can still improve function years later. The assessment tells you what is realistic for your goals.
Why was I told recovery stops at six months?
The fastest recovery happens in the first months and most hospital programs are time-limited, so many people hear that as a deadline. Improvement after that depends more on practice than on spontaneous recovery, but it does continue.
How often would I come?
Commonly weekly, with a daily home program, in blocks of several weeks followed by a review.
What can improve
Can physiotherapy help my arm a year after stroke?
Task-specific, repetitive practice can still improve arm and hand use in the chronic phase. The assessment, using measures such as the Fugl-Meyer, tells you what is realistic for your arm.
Does Alberta Health cover stroke physiotherapy at a private clinic?
In most cases, no. AHS funds physiotherapy only in specific situations such as after a fracture or joint replacement. Extended health plans usually cover part of the cost.
