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Stroke Recovery Progress Tracking Chart

A comprehensive tool for monitoring post-stroke rehabilitation progress

Neurology

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Last updated: Mar 24, 2025

Patient Information

Name: ________________________ Date of Stroke: ________________ Type of Stroke: ________________

Daily Activities Progress Tracker

Mobility & Physical Function (Rate 1-5)

  • Walking independently: ⬜ ⬜ ⬜ ⬜ ⬜
  • Balance while standing: ⬜ ⬜ ⬜ ⬜ ⬜
  • Arm movement: ⬜ ⬜ ⬜ ⬜ ⬜
  • Hand grip strength: ⬜ ⬜ ⬜ ⬜ ⬜

Speech & Communication (Rate 1-5)

  • Word formation: ⬜ ⬜ ⬜ ⬜ ⬜
  • Sentence comprehension: ⬜ ⬜ ⬜ ⬜ ⬜
  • Reading ability: ⬜ ⬜ ⬜ ⬜ ⬜

Daily Living Activities (Rate 1-5)

  • Eating independently: ⬜ ⬜ ⬜ ⬜ ⬜
  • Dressing: ⬜ ⬜ ⬜ ⬜ ⬜
  • Personal hygiene: ⬜ ⬜ ⬜ ⬜ ⬜

Weekly Goals

  1. Physical Therapy Goals:

  2. Occupational Therapy Goals:

  3. Speech Therapy Goals:

Medical Appointments

Date Provider Notes

Medication Tracking

Medication Dosage Time Taken

Rating Scale: 1 = Requires complete assistance 2 = Requires significant assistance 3 = Requires moderate assistance 4 = Requires minimal assistance 5 = Independent

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