Each year, 16 million people worldwide are affected by a first-time stroke. Of these 16 million, 10 million people survive with some form of deficit. Here are presented physical assessment for stroke patient. One of the assessments were called as The Berg Balance Scale (BBS) is a functional
outcome measure in the International Classification of Functioning domain of activity, meaning it has the ability to measure a patient’s ability to execute a task or action. Based on review of the literature, it is shown that the BBS has excellent test-retest, intra- and inter-rater reliability, as well as excellent internal consistency (Megan Kudlac, 2019). Other than that, we also can use Timed Up and Go Test (TUG) which is a single-task measure involves a single 180-degree turn and straight pathway walking.
It shown that, the test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated better responsiveness than TUG and BBS. The results of the present study support the use of these scales for measuring

Berg Balance Test and Time Up and Go Test

Other than the assessment that physiotherapy can do to assess. Client can also take care of their own diet to prevent 2nd stroke to happen. For patient who had stroke can be advise to consume more vitamin B12. Vitamin B12 along with other B-vitamins, acts as co-factors for specific enzymes to carry out metabolic functions in the body. Some of the richest sources are liver, beef, sardines, clams, and dairy products. A vitamin B12 deficiency results in increased levels of homocysteine, which is a risk factor for stroke. The literature demonstrates that patients with a vitamin B12 deficiency and
hyperhomocysteinemia during an ischemic stroke have been reported to have worse outcomes (Poole, 2022). Recent data suggest that vitamin B12 plays an important antioxidant role in the body and when levels are reduced, there is more oxidation present (Erik E. van de Lagemaat 1, 2019)
For the treatment that we can take as guideline for stroke patients is categorized into 3 categories which are through mirror therapy, acupuncture and exercise. Mirror therapy or visual feedback therapy (VFT) has been used as an optional therapy for the rehabilitation of patients with
neurological disorders (Zhu, 2020). This therapy is based on visual stimulation. This visual feedback is given to the individual using a mirror that reflects the nonaffected limb to make the brain believe
that what the individual sees is the affected limb moving without difficulty (Jaafar, 2021). Treatment included 8 weeks of training and patients were instructed to practice actions involved in activities of daily living as shown on the television screen. From these article it shown that, motion observation therapy based on the mirror neuron theory can promote plasticity change and functional reorganization of the brain through activation of the mirror neuron system and accelerate restoration
of upper limb function of stroke patients (Zhu, 2020). The majority of the studies showed positive effects of MT on upper limb recovery. In stroke rehabilitation, the proportional recovery rule is widely accepted. There is a “critical window for recovery” within the first 3–6 months poststroke, and this duration enhanced neuroplasticity mechanisms triggered by the injury (Jaafar, 2021). MT may be considered for rehabilitation programs for individuals with chronic stroke to facilitate better outcomes.

Next, through exercise which emphasize more on core stability can help in coordination movement for post stroke patients. Which stated by (Olczak, 2021) that better core stability can improved the precise movement of the trunk in both the frontal and sagittal and also favored higher elevation of the feet while walking and a faster gait. We found that a total of about 20 min/d for 20 days of exercises to improve core stability increased trunk performance, particularly in terms of dynamic sitting balance (Haruyama, 2017).

Lastly shown that acupuncture treatments were given in 24 sessions over 4 weeks, with 3- month follow-up period. The treatment group received acupuncture treatment beside the conventional therapy. The main points chosen were Baihui (GV20) and Taiyang (EXHN5). The limb points were
selected based on hemiplegia phase. For atonic phase, the following points were chosen are Jianyu(LI15), Jianzhen(SI9), Quchi(LI11), Waiguan(TE5), Hegu(LI4), Huantiao(GB30), Fengshi(GB31), Xiyangguan (GB33), Yanglingquan(GB34), Xuanzhong(GB39), Kunlun(BL60); For
spasm stage, the following limb points were selected: Jiquan(HT1), Chize(LU5), Neiguan(PC7), Daling(PC7), Yinmen(BL37), Xiyangguan(GB33), Fuxi(BL38), Yanglingquan(GB34), Tiaokou(ST38), Zusanli(ST36), Taichong(LR3) (Wang, 2020). Acupuncture may promote the motor function recovery of haemorrhagic stroke patients in subacute phase mainly by enhancing the lower-limb ability.

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