Stroke Recovery Weekly Tracker, Upper Limb & ADL Progress

Why track

Stroke recovery does not move in a straight line. Some weeks feel like nothing happens. Some weeks you suddenly do something that was impossible last week. Written records catch the pattern your memory misses, and give your OT and physio something concrete to adjust the plan on.

Fill the tracker once a week, always on the same day. Keep it brief. Five minutes is enough.

Shoulder and arm movement

Score each on a 0 to 5 scale. 0 means no movement. 3 means you can move against gravity but not far. 5 means normal.

1. Lift arm straight up to the ceiling.
2. Lift arm straight out to the side.
3. Touch back of head with hand.
4. Touch small of back with hand.
5. Reach across body to opposite shoulder.

Elbow and forearm

1. Bend elbow to touch own shoulder.
2. Straighten elbow fully.
3. Turn palm up (supination).
4. Turn palm down (pronation).

Wrist and hand

1. Bend wrist up.
2. Bend wrist down.
3. Make a fist.
4. Open hand fully.
5. Touch thumb to each finger tip in turn.
6. Pinch a small coin.
7. Squeeze a rolled-up sock.

Grip strength

If you have a dynamometer, record affected and unaffected hand numbers each week. If not, use this functional test: pick up a full 500ml water bottle and hold for 30 seconds. Record yes or no. Once you can do it, progress to a 1kg weight, then 2kg.

Daily living tasks (rate yourself 0 to 4)

0 = cannot do at all. 1 = can do with heavy help. 2 = can do with some help or equipment. 3 = can do alone but slowly. 4 = do it normally.

• Feed self with spoon or fork.
• Drink from a cup with the affected hand.
• Brush teeth.
• Wash hair.
• Put on a shirt.
• Put on trousers.
• Put on socks and shoes.
• Do up buttons.
• Go to the toilet unaided.
• Stand up from a chair.
• Walk 10 steps.
• Walk outside to the car.
• Prepare a simple meal (toast, noodles).
• Use a phone (call, text, WhatsApp).
• Write your own name legibly.

Mobility and balance

1. Stand for 1 minute without support.
2. Walk 10 metres without a walking aid.
3. Walk up 5 stairs with handrail.
4. Walk up 5 stairs without handrail.
5. Step sideways over a small obstacle.

Fatigue and sleep

Each day, note: hours slept, fatigue level (0 to 10), and the time of day when fatigue hit hardest. Patterns usually show within two weeks. Schedule therapy and the hardest tasks at your best time.

Weekly review prompts

At the end of each week, answer these four questions in one sentence each:

1. What is one thing I can do this week that I could not do last week?
2. What is one thing that feels harder than last week?
3. What equipment or adaptation helped most?
4. What question do I want to ask my OT or physio this week?

Bring this page to every therapy appointment. The therapist adjusts exercises and goals based on what you bring, not on what they remember. Written numbers are more convincing than "I feel a bit better".

Red flags, stop and call the doctor

• New or worsening weakness in any limb.
• New facial droop.
• Sudden severe headache.
• New slurred speech.
• New vision loss.
• Balance suddenly much worse.

These can be a second stroke. Do not wait for an appointment; go to the emergency department.