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Complete the Post-Stroke Checklist*

It is important that you assess any physical challenges caused by your stroke from time to time. Answer the following questions, print your response, and bring it with you to your next appointment with your family doctor. It can help him/her know if you may benefit from care from a Stroke Rehabilitation Specialist.

Since your stroke or last assessment:

Post-Stroke Checklist Summary

Please answer all the questions.

1. Have you received medical advice on health-related lifestyle changes or medications to prevent another stroke?

2. Are you finding it more difficult to take care of yourself?

Do you have difficulty:

3. Are you finding it difficult to walk more or move safely (i.e., from bed to chair)?

Are you continuing to receive rehabilitation therapy?

4. Do you have increase stiffness in your arms, hands, or legs?

Is this interfering with activities of daily living?

5. Do you have any new pain?

6. Are you having more problems controlling your bladder or bowels?

7. Are you finding it more difficult to communicate?

8. Do you feel more anxious or depressed?

9. Are you finding it more difficult to think, concentrate, or remember things?

Is this interfering with activities of daily living?

10. Are you finding it more difficult to carry out leisureactivities, hobbies, or engage in sexual activity?

11. Have your personal relationships (with family, friends or others) become more difficult or strained?

12. Are you experiencing fatigue that is interfering with your ability to do your exercises or other activities?

13. Do you have other challenges or concerns related to your stroke that are interfering with your recovery or causing you distress?

If you answered “YES” to any of the questions above, you may benefit from seeing a Stroke Rehabilitation Specialist. Speak to your doctor about getting a referral to help you manage the physical challenges associated with your stroke.

*Adapted from the Heart and Stroke Foundation Post-Stroke Checklist. Developed by the Global Stroke Community Advisory Panel (2012), endorsed by the World Stroke Organization, adapted by the Heart and Stroke Foundation Canadian Stroke Best Practice Recommendations development team (2014).

Download the Post-Stroke Checklist (PDF)

Trying to regain strength can feel daunting. You don’t have to go at it alone.

Talk to your doctor to get a referral to a Stroke Rehabilitation Specialist who can work with you to create a treatment plan.

Complete the Post-Stroke Quiz

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