Post-Stroke Recovery Progress Tracker

Patient Information

Name: ___________________ Date of Stroke: ___________________ Physician: ________________ Contact: ________________________

Daily Activities Tracking

Mobility (Rate 1-5)

• Walking: ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5
• Balance: ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5
• Transfers: ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5

Speech & Communication

• Words spoken clearly today: _____
• Reading comprehension (mins): _____
• Communication difficulties: ☐ Yes ☐ No

Upper Extremity Function

• Right arm strength (1-5): _____
• Left arm strength (1-5): _____
• Fine motor tasks completed: _____

Daily Living Activities

• Dressing independently: ☐ Yes ☐ No ☐ Partial
• Feeding independently: ☐ Yes ☐ No ☐ Partial
• Personal hygiene: ☐ Yes ☐ No ☐ Partial

Medication Adherence

• Morning meds taken: ☐
• Afternoon meds taken: ☐
• Evening meds taken: ☐

Symptoms & Concerns

• Pain level (0-10): _____
• Fatigue level (0-10): _____
• New symptoms: ________________

Therapy Sessions

• Type: ________________
• Duration: ____________
• Progress notes: ________

Weekly Goals

Share this tracking sheet with your healthcare team at each visit