If you are considering occupational therapy as a treatment for stroke rehabilitation recovery, we want you to be as informed as possible—so we, as OTs, can truly partner to create the best course of treatment for YOU.
In occupational therapy, we tend to work from “menus” of evidence-based assessments and treatments. This gives us the flexibility to meet the specific needs of each patient. Below, you’ll find the assessment and treatment options your therapist may use, along with the evidence supporting them.
You will also find stroke rehab therapists near you.

Please note that this page is for educational purposes and does not substitute advice from your medical provider. At the bottom of this page, you’ll find occupational therapy professionals near you who can support you in your stroke rehabilitation recovery.
Why pursue occupational therapy after a stroke?
This article focuses on therapy treatment for stroke rehabilitation.
When providing stroke rehabilitation treatment, your occupational therapist will help you modify or adapt your activities of daily living—such as your sleep routine, meal preparation, social participation, bathing, dressing, and home management—in addition to helping you return to the activities that are meaningful to you. These interventions are tailored to you as an individual, with consideration of your specific interests, wants, and needs. Through therapy, lifestyle adjustments, and healthy habits, you may reduce your risk of having a second stroke.
Investing in therapy early is important, because occupational therapy can help decrease the overall cost of stroke treatment by improving patient independence, reducing hospital readmissions, and potentially decreasing the need for long-term care.1
The average lifetime cost of stroke per person ranges from $90,981–$228,030 depending on the type of stroke.2 Averaged across all individuals and types of stroke, the lifetime cost per person is about $103,576. Research indicates that approximately 11% of individuals will experience an additional stroke within a year of their first, and this number rises to 26% within 5 years.3
By contrast, based on this study out of Europe, early occupational therapy costs around $5,813 per person for inpatient stroke rehab and $2,061 for outpatient stroke rehab. In addition to potentially reducing your risk of having a second stroke in the future, this treatment route also focuses on helping you return to the activities that are meaningful to you—making it an important option for many people.
Therapist-recommended assessments for stroke rehab
As you can see below, evaluating symptoms of a stroke involves many different components. That’s partly because several areas of overall body function can be affected—especially within the context of your everyday life. A thorough examination will help identify the major “focus areas” for therapy that are currently contributing to your deficits. Assessments also serve as a point of comparison for tracking your progress and response to treatment over time.
An accurate and thorough baseline allows your therapist (and you!) to discern how much the interventions are helping. Your therapist may perform certain assessments at various intervals over the course of therapy. Members of the OT Potential Club can log in to see these assessments broken down by acute, subacute, and chronic. They’ll also find additional information about each assessment.
Core Occupational Therapy Outcome Measures
In occupational therapy, one of our core outcome measures is your self-report on your quality of life. At the end of the day, this is the most important outcome for us. We want our treatments to have a significant impact on your day-to-day life.
- Quality of Life Patient Reported Outcome Measure – The PROMIS Global 10
Possible Assessments for Stroke Rehabilitation
Gathered from Canadian Stroke Best Practices and Pedretti’s Occupational Therapy.
Functional Capacity and Activities of Daily Living
- 10 Meter Walk Test
- 6 Minute Walk Test
- ABILHAND
- Activity Card Sort
- Addenbrooke’s Cognitive Examination
- Allen Cognitive Level Screen
- AlphaFIM®
- Assessment of Life Habits
- Assessment of Motor and Processing
- Barthel Index for ADLs
- Beck Depression Inventory
- Canadian Occupational Performance Measure
- Clock Drawing Test
- Cognitive Performance Test
- Executive Function Performance Test
- Frenchay Activities Index
- Kettle Test
- Kohlman Evaluation of Living Skills
- Lawton Instrumental Activities of Daily Living
- Menu Task
- Modified Rankin Scale
- Multiple Errands Test
- Stroke Impact Scale
- Weekly Calendar Planning Activity
Motor Function
- Chedoke-McMaster Stroke Assessment Scale
- Fugl Meyer Assessment
- Grip Strength
- Manual Muscle Test
- Motor Assessment Scale
- Motricity Index for Motor Impairment After Stroke
- Pinch Strength
- Rivermead Motor Assessment
- Stroke Rehabilitation Assessment of Movement
Mobility
- Berg Balance Scale
- Clinical Outcome Variables
- Functional Ambulation Categories
- Functional Reach Test
- Mini BESTest
- Postural Assessment Scale for Stroke
- Range of Motion
- Rivermead Mobility Index
- Timed “Up and Go” Test
- Tinetti Performance Oriented Mobility Test
- Trunk Control Test
Upper Extremity
- Action Research Arm Test
- Arm Motor Ability Test
- Box and Blocks
- Chedoke Arm and Hand Activity Inventory
- Moberg Pick Up Test
- Motor Activity Log
- Nine Hole Peg Test
- Semmes Weinstein Monofilament Test
- TEMPA
- Weber Two Point Discrimination Test
- Wolf Motor Function Test
Mood and Cognition
- Addenbrooke’s Cognitive Examination
- Beck Depression Inventory
- Clock Drawing Test
- Cognistat Cognitive Assessment
- Cognitive Log
- General Health Questionnaire
- Geriatric Depression Scale
- Hospital Anxiety and Depression Scale
- Medical Outcomes Study Short-Form Health Survey
- Mini-Mental State Examination
- Montreal Cognitive Assessment
- Patient Health Questionnaire-9
- Saint Louis University Mental Status Exam
- Trail Making Test
Visual Perception and Neglect
- Behavioral Inattention Test
- Line Bisection Test
- Motor-Free Visual Perception Test
Spasticity
- Modified Ashworth Scale
- Modified Tardieu Scale
Stroke Severity
- Arnadottir Occupational Therapy Neurobehavioral Evaluation
- Canadian Neurological Scale
- Glasgow Coma Scale
- NIH Stroke Scale
- Orpington Prognostic Scale
- Sickness Impact Profile
Setting occupational therapy goals for stroke rehab
Therapy works best when there is buy-in from the patient. It is important that you work with your therapist to set treatment goals that truly reflect what’s important to you. Goals in stroke rehabilitation often fall under these categories: Functional Capacity and ADLs/iADLs; Motor Function; Mobility; Upper Extremity; Mood & Cognition; Visual Perception & Neglect; and Spasticity.
Occupational therapy treatment interventions for stroke patients
After a thorough evaluation and goal-setting process, it is time to start making progress. Below are treatment interventions that can be implemented as part of a holistic therapy program.
🟢 = Strong support in evidence
🟡 = Moderate support in evidence
Based on: Occupational Therapy Practice Guidelines for Adults with Stroke
Activities of Daily Living (ADL) and Functional Mobility Interventions
- 🟢 Balance Training as Intervention to Support Occupation 5,6,7
- 🟢 Mental Imagery with Task-Oriented Training 8,9
- 🟢 Mirror Therapy with Task-Oriented Training 10,11,12
- 🟢 Stroke Self-Management Interventions 13,14
- 🟡 Action Observation with Task-Oriented Training 15
- 🟡 Activity-Based Interventions 16 (such as computer-based training for visual scanning training and optokinetic stimulation, mental practice, mirror therapy, voluntary trunk rotation, and vestibular rehabilitation)
- 🟡 Aquatic / Hydrotherapy Activity 17
- 🟡 Cognitive Behavioral Therapy (CBT) Interventions in Group or Individual Sessions 18
- 🟡 Early Mobilization 19
- 🟡 Home-Based ADL Training Before Discharge from Inpatient Rehabilitation 20
- 🟡 Home-Based ADL Training and Education 21
- 🟡 OT-Provided ADL Training Strategies 22
- 🟡 Recreational Interventions 23,24,25 (such as music, horse riding, or creative arts activities)
- 🟡 Sensory Retraining 26
- 🟡Upper Extremity Passive Range of Motion (PROM) 27
Instrumental Activities of Daily Living Interventions
- 🟢 Constraint-Induced Movement Therapy (CIMT) or CIMT in Combination with Other Interventions 28,29,20,31 (self-regulation, trunk restraint, robotic therapy, shaping, adaptive, and repetitive practice of functional tasks)
- 🟡 Driving Simulations 32
- 🟡 Health Empowerment Group with Individual Follow-Up 33
- 🟡Medication Adherence via Text Reminders and Environmental Cues 34,35
Social Participation Interventions
- 🟡 Balance Interventions: Group CBT Interventions for Balance Self-Efficacy and Task-Oriented Balance Training 16
- 🟡 Long-Term Walking, Strength, and Balance Group Intervention 36
- 🟡 Multimodal Stroke Education with Supportive Follow-Up 37,38
Stroke Rehab Interventions Involving the Caregiver
- 🟢 Family Support Organizer: Tailored Long-Term Support (before and after discharge) 39,40,41
- 🟢 Problem Solving and Cognitive Behavioral Therapy Techniques (in-person and with telephone follow-up) 42,43
- 🟢 Problem-Solving Skills Training with Stroke Education 44,45,46,47
- 🟡 Home-Based Long-Term Support and Education 48 (for ADL training, problem solving, identification of caregiver supports, coping, and stress management)
- 🟡 Inpatient, Home, and Telephone Follow-Up Intervention Focusing on Preparation for Discharge, Social Functioning, and Quality of Life 49,50
- 🟡 Multimodal Long-Term Intervention (individual or group) for Education, Coping, Problem Solving, and Stress Management 51,52
- 🟡 Problem Solving Without Additional Interventions 53,54
- 🟡 Skills Training 55,56 (such as ADLs, pressure ulcer prevention, transfers, and oral health care—before and after discharge in-home follow-up and postdischarge in-home training with telephone follow-up)
- 🟡 Two-Month Telephone Education and Support Group with Individual Stress Reduction Techniques57
Discharge suggestions
Every person is unique, so your individual response to therapy will also be unique. We recommend that you:
- Follow your therapist’s discharge recommendations to maintain progress made in therapy.
- Continue to use self-management and empowerment strategies to control any remaining symptoms.
- Follow a home exercise program to help establish good habits for body mechanics, even if you feel like you’re back to 100% function.
- Consult your therapist immediately if your condition worsens, or if you continue to have difficulty with your daily activities after 3 months.
- Follow the Stroke Discharge Checklist (stroke.org).
- Make an emergency action plan.
- Adhere to self-management strategies.
- Includes physical activity, healthy diet, sleep hygiene, well-being, and leisure
- Know how to recognize a second stroke (think FAST):
- F: face drooping
- A: arm weakness
- S: speech difficulties
- T: time to call 911
Choosing a therapist near you for stroke rehab
Occupational therapists, physical therapists, and speech language pathologists are critical care providers in the realm of stroke rehabilitation. The initial phases of stroke rehabilitation are typically delivered in an acute care setting, so you will be working with the rehab team in your hospital.
As you transition into rehab in the outpatient setting, you will likely have a wider variety of choices for therapists to work with.
Below, you can find occupational therapy professionals who have tagged “stroke” as a focus area.
Conclusion
Hopefully this article helped you understand what therapy for stroke rehabilitation entails.
This article is updated once per month based on newly released research. If you have any research you would like us to consider, please drop it in the comments.
Therapists who would like more detailed information on stroke rehabilitation best practices can join us as members of the OT Potential Club.
Article by
Ella Vanderpool, B.S., is a class of 2025 EL-OTD student with aspirations to work in the inpatient neuro rehabilitation setting. She completed one of her clinical fieldwork rotations working with stroke and spinal cord patients at the Mayo Clinic in 2024. This article was completed as part of her doctoral capstone experience.
Edited by
Brooke Andrus is the Head of Content at OT Potential, bringing over a decade of experience strategizing, building, and executing on content marketing plans for successful healthcare tech startups in the rehab therapy and behavioral health spaces.
References
Here’s the science that backs the assessment and treatment outlined above.
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- Cheng HY, Chair SY, Chau JPC. Effectiveness of a strength-oriented psychoeducation on caregiving competence, problem-solving abilities, psychosocial outcomes and physical health among family caregiver of stroke survivors: A randomised controlled trial. International Journal of Nursing Studies. 2018.
- Deyhoul N, Vasli P, Rohani C, Shakeri N, Hosseini M. The effect of family-centered empowerment program on the family caregiver burden and the activities of daily living of Iranian patients with stroke: a randomized controlled trial study. Aging Clin Exp Res. 2020.
- Perrin PB, Johnston A, Vogel B, et al. A culturally sensitive Transition Assistance Program for stroke caregivers Examining caregiver mental health and stroke rehabilitation. Journal of Rehabilitation Research and Development. 2010.
- Ostwald SK, Godwin KM, Cron SG, Kelley CP, Hersch G, Davis S. Home-based psychoeducational and mailed information programs for stroke-caregiving dyads post-discharge: a randomized trial. Disability and Rehabilitation. 2014.
- Shyu YIL, Chen MC, Chen ST, Wang HP, Shao JH. A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers. Journal of Clinical Nursing. 2008.
- Shyu YIL, Kuo LM, Chen MC, Chen ST. A clinical trial of an individualised intervention programme for family caregivers of older stroke victims in Taiwan. Journal of Clinical Nursing. 2010
- Van den Heuvel, Elisabeth TP, de Witte LP, Nooyen-Haazen I, Sanderman R, Meyboom-de Jong B. Short-term effects of a group support program and an individual support program for caregivers of stroke patients. Patient Education and Counseling. 2000.
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- Grant JS, Elliott TR, Weaver M, Bartolucci AA, Giger JN. Telephone Intervention With Family Caregivers of Stroke Survivors After Rehabilitation. Stroke. 2002.
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- Kuo YW, Yen M, Fetzer S, et al. A home-based training programme improves family caregivers’ oral care practices with stroke survivors: a randomized controlled trial. International Journal of Dental Hygiene. 2016.
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Additional References
- American Stroke Association. (2025). American Stroke Association. Stroke.org.
- Hildebrand, M., Geller, D., & Proffitt, R. (2023). Occupational Therapy Practice Guidelines for Adults With Stroke. PubMed.
- Heart and Stroke Foundation of Canada. (2019). Rehabilitation and Recovery following Stroke. Canadian Stroke Best Practices.
- Pendleton, H. M., & Schultz-Krohn, W. (2018). Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (8th ed.). Elsevier.
OT Potential does not endorse any treatments, procedures, products, or therapists referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking medical advice should consult their medical provider.