No enagagement with physio in hospital

Hello there. My mum had an acute ischemic stroke on 2nd March and is currently receiving treatment in an adult rehabilitation unit. She is progressing well, engaging with the OT and speech and language, however she will absolutely not engage with the physio team at all. She has not taken to the physiotherapist at all, who doesn’t have the best bedside manner. We and the physio team are concerned that if she continues to refuse physio, then she will not be able to gain her mobility as she will have so much muscle wastage. There is another physio on the ward that my mum likes, but she only works part-time. We just don’t know what else to do. We’ve been there when she has physio to support her, we’ve tried it where we’re not there to see if it makes a difference, but she just won’t engage. She gets distressed and angry and shouts at them. We just don’t know what to do, and I was wondering if anyone else has experienced this with a loved one, and if you have any advice on how we can help her. Thanks.


Hello there,

not uncommon. Tell me, how old is your mum, and can she stand-up, walk with zimmer, or stick? Just to get an idea. You could talk her through some exercises, presumably? Get her to stand on one leg (the affected side) if possible. If not, just standing. Really depends on what she can do to get started, and that’s impossible for me to know, based on your post so far

good luck, Roland


Hi Roland, thanks for replying. My mum is 69. She is able to stand and walk with support. She hasn’t been offered a zimmer frame yet, or maybe she has but has refused! We haven’t always been able to be there when the physio shows up. She has surprised us, as she is able to move her affected side quite well. She’s a strong cookie. From reading the Stroke Association website, that physio in the early days is so important. We’re almost 4 weeks in and she’s still refusing. Could this have a detrimental affect on her recovery, or is she doing enough, by the little spurts of walking she does of her own accord? Thanks, Danielle


@DanCetCol hi & welcome to the forum. Sorry you’ve had cause to join us but hopefully you’ll find it a useful place to be.

Is it possible to ask for another physio? Its very difficult when they take a dislike to someone. I didn’t like one of the physios i had in hospital and was always relieved when she went elsewhere. You say she can walk with support so as long as she is moving a little that is probably ok for now. You could also try doing some leg exercises with her sitting down e.g marching. Have a look on internet to see if you can find something she might be able to do.

Stroke can affect someones mood / temperament & maybe that is playing a part. That should ease over time so bear with it if you can.

Best wishes to you both

Ann x

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Hi Danielle,

things are looking up then. Let me just say that the majority of patients do nothing in between weekly physio, mainly because they hate it. So your mum could actually be doing a lot more than those who hate their physio. Her possibilities are endless, and if she if a hard worker, she can do whatever she puts her mind to. Once she can get on the floor, she can address her “weak” core more fully, which will need looking after.

Lookup some exercises on Youtube, and do some with her. I do have weekly physio, and yoga, I’m 59, stroke 1.5 years ago, and still walk with a stick. Your mum will recover well, if you can join in, and motivate her. Eventually try some Qigong, but I’ve a hunch she will do well,

Good luck to her (& you) , Roland


Hi @DanCetCol and welcome to the forum :smile:

Any activity, be it mental or physical is absolutely draining, just speaking from my own experience. So it will only come in short burst, 5mins here, 15mins somewhere else, so rest and sleep take up the majority of the day. The brain has a lot to learn and master again, there’s a lot for it to process and takes a lot of concentration. So it’s no wonder it is all so draining for her. But as time goes on this will improve, but it’s takes a lot more time than you would expect.

The fact that she has no zimmer frame is a good sign as it shows great promise in her ability to get around. I never had one either as you can become too dependent on them and can become detrimental to your progress.
Does your mum get up and about visiting with other patients at all, that you wouldn’t necessarily be privy to not being there throughout the day. Even just sitting up in bed or in a chair can whilst talking patients around you is exhausting.

We are like babies who are taking their first steps, they wind up sitting or crawling more than actual walking, or “surfing the furniture”, when they first start. But it comes on over the weeks and months as muscles strengthen and the brain embeds the mechanics of it.

In the meantime look up chair based exercises for the elderly as they will have lots exercises such as sit to stand, which will help strengthen her legs greatly.

Another option, if you can afford it, is you could have a private physiotherapist to visit her during her stay in rehab, that is perfectly acceptable. Some people do that to supplement their treatment, and you find one she gets on better with.


Hi @DanCetCol
Hello and welcome :slight_smile:
The other have said most of the pertinent stuff

To summarise and maybe extend a little: It takes a great deal of effort to recover that is not discernable externally - You might do an internet search on the topic of ‘spoons’ Here’s a pdf

Any movement is good. Stroke recovery is a marathon not a sprint so don’t worry about the first few weeks - But you are partly right to talk about muscle wastage BUT much more significant is that this is the time when habits that favour the strong side will develop that will have to be undone later If a more complete recovery is sort.
In my experience the NHS does not have any mechanism for fitting people’s personalities - something that is crucial in personal services of which physiotherapy is definitely one. I would talk to the ward sister or management team about reassignment but don’t hold your breath - I would suggest she/you are better off self-curating exercises than using spoons dealing with a unpleasant PT.

If as Roland said your mum is motivated then if you go to the menus of this forum select videos and then look for the red amber or green group these are physiotherapy regimes for the chair bound the semi-mobile and the walking free. If you sign up to the online activities section of the stroke association website and talk to Nicola @online.activities then she can join some group zoom calls that do a weekly exercise class based on these videos.

If you use the YouTube channels that are listed in this post you’ll also see an endless selection of PT exercises. Just find the edge of your mum’s capability has it progresses and select exercises that straddle the boundary

You may well find

[No idea where it gets the idea of 16 minutes read time that might be the whole thread but not the 40 things]
Useful too because it will give you some insight that you probably are not able to discern on your own.

A final thought that is in the above and other people’s posts but not explicit is be there to support your mum is important while being there and pushing her can be VERY counterproductive - there’s a lot you’ve can’t see within her head about emotions, learning to live in a body where the automated and manual controls no longer work, and a lot more you’ll only discover if you read it a few hundred or thousand posts on here

Give her a hug and think how lucky you are she’s still here



Very well put Simon, that’s another one to bookmarking for future posts to link back to :blush:

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