The hospital has a department for physiotherapy. The doctor will refer the patient to this department and it is also important for the caregiver to follow to see and learn how this physiotherapy is done. The caregiver can then adapt the principles so that this exercise can be carried out at home. Different paralysis will require different methods. Here I can only mention the methods I use.

The stationary exercise bicycle is used to exercise the legs. The seat is removed. The patient is seated on his chair and this machine is placed closed, in front of him. The foot of the paralyzed leg is put on the pedal and a length of cloth tied around the pedal so that the foot will remain on the pedal and does not slip out. With the healthy foot the patient can then begin to cycle. The length of time will depend on the patient. Usually I insist that the patient cycle for at least fifteen minutes.

For the arm, there is a device sold which has two hand grips attached to a length of rope. In between there are two pulleys and a bracket which can be attached to a door frame. With the device hanging on the door, the patient can hold the hand grip and pull. Tie the paralyzed hand to the hand grip with a length of cloth so that it will stay in place. With the healthy hand, the patient can then begin to pull and as he does so, one hand will rise while the other goes down and vice versa.

I installed a six foot bar on the wall for the purpose of the patient to hold and slowly walk from one end to the other. There is an aid available to wrap around the paralyzed leg from the thigh to the ankle so that the knee is straight. This device gives support to the weaken leg in the exercise.

Physiotherapy should be adapted to suit the patient's need. Hence one has to be innovative and resourceful in developing the various exercises. Small items like a spongy rubber ball, the size of a tennis ball, can be used to exercise the weaken fingers by asking the patient to hold the ball in the palm and try to squeeze it with the fingers. Another way is to use an empty plastic cup and ask the patient to hold using the weaken hand and slowly lift the cup to the mouth as though he is taking a drink.

The National Stroke Association of Malaysia conducts different therapy and also provides counselling for stroke patients at the centre. For stroke patients who have a chance to rehabilitate themselves, this is a good option to consider. They have to go to the centre in the morning on weekdays where trained personnels and volunteers assist stroke patients to perform different exercises. One such centre is at No.12 Jalan 7/2, 46050 Petaling Jaya, Selangor (phone no. 03-79564840) or visit the website at http://www.nasam.org.