Can AI help me find good therapy for stroke? Part 2
Can AI help stroke survivors find good care?
Following my last post regarding what Gemini AI had to say about my profession, I next wanted to know if AI was capable of helping people find good care for stroke. After my query about “What is an NCS Physical Therapist,” Gemini prompted, “Would you like me to help you find the specific questions you should ask a physical therapist during an initial evaluation to see if they have the right neuro-experience for your needs?” Here is what it came up with (my responses are highlighted with this symbol *** )
When interviewing a physical therapist (PT) to see if they are the right fit for stroke recovery, you want to move past general questions and dig into their clinical decision-making. A therapist can be "nice," but for stroke, you need someone who understands how to drive neuroplasticity. ***Very true***
Here are the high-value questions you should ask, along with what a "good" answer sounds like:
1. The "Specialization" Question
"What percentage of your current caseload is neurologic, specifically stroke survivors?"
Why it matters: Many outpatient clinics primarily treat orthopedic issues (back pain, ACL tears). You don't want a "generalist" who only sees one stroke patient a month.
The Right Answer: "At least 50% of my patients have neurological conditions," or "I am part of the dedicated neuro-rehab team here." ***True. We have a primarily geriatric and neurological population at APT***
2. The "Neuroplasticity" Question
"How do you incorporate 'High-Intensity Gait Training' or 'Task-Specific Priming' into your sessions?"
Why it matters: Research shows that for the brain to rewire, the heart rate needs to reach a certain threshold, and movements must be repetitive and meaningful. ***This is oversimplified. It’s not just about heart rate. Intensity matters, and repetition matters ***
The Right Answer: They should mention monitoring your heart rate or using "forced use" (making you use the affected side) rather than just doing simple stretching on a table. ***YES to Forced Use. The latest research is showing huge benefits to learning/neuroplasticity with the use of forced-use task-based interventions***
3. The "Equipment" Question
"What specialized technology or equipment do you use for gait (walking) and upper extremity recovery?"
Why it matters: Stroke rehab in 2026 often involves tools that help you do more reps than a human therapist can provide alone. ***Not true. The form and muscle engagement is much more important than reps. When left to their own, stroke survivors tend to “cheat” and use muscles that are easy to engage (the unaffected side) instead of the muscles that are impaired (the affected side). This can lead to performing repeptitions of a movement without the desired muscle engagement leading to learned non-use***
The Right Answer: Look for mentions of Body-Weight Support Systems, Functional Electrical Stimulation (FES), Robotic Exoskeletons, or even Virtual Reality for balance. ***The Academy of Neurologic Physical Therapists released data in their clinical practice guideline for 2020 strongly reject the use of body weight supported treadmill training and robot assist for persons past 6 months of injury. This is because gravity provides the intensity needed to trigger activation of muscles as well as feedback to balance and posture. Neurologic recovery is all about learning to move again. The body will learn exactly what it is taught, and if what it is being taught is how to walk in an overhead harness or robot, that is what it gets good at. You can read the literature here***
4. The "Goal Setting" Question
"How do you measure progress beyond just 'strength'?"
Why it matters: Muscle strength is only part of the battle. You need to know if your brain is coordinating that strength.
The Right Answer: They should mention standardized tests like the Berg Balance Scale, the 10-Meter Walk Test, or the Fugl-Meyer Assessment. ***Standardized tests are great in the first 6 months post stroke. In chronic cases years past initial stroke, we rely on other ways to measure progress like by functional activity or sometimes by component tasks***
Red Flags to Watch For
If you hear these, you might want to keep looking:
"We'll just do some basic leg lifts and see how it goes." (Lacks a neuro-specific plan).
"I haven't treated a stroke patient in a few years, but it’s all the same." (It is definitely not the same as ortho).
"We don't really use tech; we just use therapy bands." (Bands are fine, but usually insufficient for modern stroke recovery). ***There is so much more that a therapist can do than just use therapy bands***
Overall, I think Gemini did a good job providing pretty accurate information for these queries. AI is definitely improving quickly. Months ago I ran a search on ChatGPT with similar queries and the results were disappointing. As our online research tools improve I hope stroke survivors and the general public will find it easier to get the help they need.