Stroke Recovery Devices and Equipment

Buy for the next month, not the worst day

The days before discharge are stressful, and well-meaning relatives forward lists of things to order. The trouble is that needs change fast in the first few months. The person who leaves hospital needing a hospital bed and two people to transfer may be walking to the bathroom with a walker eight weeks later. Or may not. Nobody can tell you for certain on day one.

So a useful rule: get what keeps the person safe and comfortable this week, rent what you may outgrow, and hold off on anything expensive until a physiotherapist has seen the person at home. A walker bought at the wrong height, or a wheelchair that doesn't fit through the bathroom door, is money spent twice.

Walking aids, from walker to stick

A standard folding walker gives the most support, but it needs two working hands. Many people after a stroke can't grip properly with the affected hand, which makes a standard walker awkward or unsafe. That is where a hemi-walker (a frame used with one hand, sitting beside the person) or a quadripod stick (a stick with a small four-legged base) comes in. A single-point walking stick is the lightest support and usually comes last.

Height matters more than brand. With the person standing straight and arms relaxed, the handle should sit roughly at wrist level, so the elbow is slightly bent when holding it. Too tall and the shoulder hitches up; too short and the person stoops and leans. The aid is held in the hand on the stronger side, which surprises people, but it lets the stick move with the weak leg and share its load.

Which aid is right, and when to step down to a lighter one, is decided during walking practice. Our guide to walking and balance after stroke explains how that progression is judged.

Ankle-foot orthoses for a dropping foot

When the muscles that lift the front of the foot are weak, the toes catch the floor and the person trips, or swings the leg out to the side to clear it. An ankle-foot orthosis (AFO) is a light brace, usually plastic, that holds the foot up during walking. It goes inside the shoe, so the shoe needs to be a size or so roomier with a firm heel and a fastening that opens wide.

Ready-made AFOs can work for some people. Others need a custom one moulded by an orthotist, especially if the ankle is stiff or the foot turns inward. Check the skin after the first few days of wear for red marks that don't fade within half an hour. If the foot drop improves, the AFO may be needed only for longer walks, and later not at all. More on this in our page on foot drop and how it is managed.

Wheelchairs and transfer aids

A wheelchair is often needed for outdoor trips, hospital follow-ups and longer distances, even when the person can walk a little at home. For most families a rented or basic folding chair is enough at first. Measure the narrowest door in the house before choosing, usually the bathroom. Removable or swing-away armrests and footrests make transfers much easier.

Transfer aids reduce the strain on the family. A gait belt (a wide belt with handles, worn round the person's waist) gives the helper something safe to hold instead of pulling on the weak arm, which can injure the shoulder. A sliding transfer board helps someone who can sit but not yet stand move from bed to wheelchair. Both are cheap, and both need to be taught properly; see how transfers are practised.

Bedroom and bathroom equipment

A hospital bed with height adjustment and side rails is worth renting if the person spends most of the day in bed or needs help with repositioning. If they are getting up regularly, a normal bed at the right height (feet flat on the floor with knees at about a right angle when sitting on the edge) may be better, because it is what they'll use long term. Pushing one side of the bed against the wall, with the stronger side free for getting out, is a simple and often overlooked step. People at risk of pressure sores may need an air mattress; our page on caring for a bedridden patient covers this.

The bathroom is where many falls happen. A commode chair beside the bed saves risky night trips in the early weeks. A raised toilet seat or a toilet frame helps with standing up. A shower chair or stool lets the person bathe seated. Grab bars should be fixed into the wall properly, on the side of the stronger hand, not the suction-cup kind that can let go under load. And watch the step into the bathroom; a 10 cm lip that nobody notices day to day can be a real hazard for a dragging foot. Anti-slip mats inside and outside help.

Hand splints and arm supports

A resting hand splint holds the wrist and fingers in a stretched, comfortable position, usually at night, to reduce the risk of the hand curling into a fixed fist. It is useful for some people with rising tone in the hand and unnecessary for others. It should be prescribed after assessing the hand, not ordered online based on a photo.

For the shoulder, the evidence for slings is mixed. A sling can support a heavy, floppy arm when the person is walking, but worn all day it holds the arm in a bent position and may encourage stiffness. Supporting the arm on a pillow or table when sitting is often the better everyday habit. Ask your physiotherapist before buying one. Our guide to arm and hand recovery after stroke goes into the shoulder in detail.

Exercise machines: what helps and what to skip

Searches for an exercise machine for stroke patients turn up a lot of gadgets. A few are genuinely useful at home. A simple pedal exerciser that sits on the floor in front of a chair can help with leg movement and endurance, provided the weak foot is strapped in and doesn't slip off. Therapy bands, a few light weights and a firm step are enough for most home programmes. The physiotherapy products we recommend page lists basic items.

Be careful with vibration plates, massagers sold as paralysis cures, and home muscle stimulators bought without advice. Electrical stimulation has a place in stroke rehab, but settings, placement and timing matter, and it should be used under a physiotherapist's guidance. Our home visit kit includes a portable muscle stimulator for this reason. Larger equipment such as the overhead track and harness system, which lets people practise walking with their body weight partly supported, stays at the clinic; there is no sensible home version.

Renting, buying or borrowing stroke recovery equipment

A rough way to decide:

• Rent: hospital bed, air mattress, wheelchair (at least for the first couple of months). These are expensive and needs often change.
• Buy: walking aid fitted to the person, gait belt, commode chair, shower chair, grab bars, anti-slip mats. Cheap, personal, and used daily.
• Get assessed first: AFO, hand splint, sling, and any powered exercise device.
• Borrow with care: a relative's old walker or stick is fine if it can be adjusted to the right height and the rubber tips aren't worn smooth.

If you are setting up a home for a family member coming out of hospital, our guide to caring for a stroke patient at home covers the routine side. And when a physiotherapist comes for home stroke physiotherapy, the first visit includes a look at the room, bathroom and existing equipment, so you can check before ordering more. The wider stroke recovery guide puts all of this in context.

Frequently asked questions