What to expect

08:00 physician round and medication. 09:00–12:00 two to three therapy sessions of 30 to 45 minutes, alternating physiotherapy, robotic gait training and occupational therapy. 12:00 lunch and rest — the rest is part of the plan, not a gap in it. 13:30–16:30 two to three further sessions, which may include hydrotherapy, speech therapy or cognitive training. Late afternoon: independent practice and family training.

Recovery is fastest in the first three to six months, continues more slowly for the next two to three years, and further gains remain possible after that 5. The early period is not a deadline — it is a window in which the same hours of therapy produce more change. That is the entire reason waiting has a cost.

Plateaus are normal and are not a sign of failure. What usually helps at a plateau is changing the target rather than increasing the effort — a plateau in walking speed often coincides with real gains in endurance or confidence, which the measurements show and daily life hides.

Families are frequently told the arm is not improving when in fact it is improving more slowly than the leg. Arm and hand movement needs finer control from a larger area of brain, so it takes longer. It is not a sign that therapy is failing, and it is one of the reasons we measure the arm separately with the Fugl-Meyer upper limb subscale.