In the late 90s, a group of scientists discovered that after a stroke, brain functions responsible for language migrated from the stroke-damaged area to the corresponding area on the undamaged side of the brain.

Some patients are able to relearn language and communication skills with the help of a speech therapist.

This was huge news, because with functional magnetic resonance imaging (fMRI), scientists were actually able to see the ways in which the brain adapts to a stroke and heals.

This ability of the brain to reorganise its functions is called 'plasticity'.

The process begins as soon as a day or two after the stroke and so it is important that the patient starts getting rehabilitation as early as possible.

Said Dr Kong Keng He, senior consultant at the department of rehabilitation medicine, Tan Tock Seng Hospital (TTSH): 'As soon as the patient is stable, which is in about two days after a mild to moderate stroke, the physiotherapist and occupational therapist will get him moving.'

The benefits are twofold: Patients recover faster and are less likely to have complications such as chest infections, urinary tract problems and bed sores.

Generally, stroke patients have varying degrees of weakness on one side and coordination problems. Even those who had a mild attack may find it affects their mental abilities. They may be unable to concentrate or figure out maps, for example.

According to Dr Kong, the aim of rehabilitation is to help patients adjust to 'active daily living' tasks such as feeding themselves, walking, bathing, dressing and grooming.

Rehabilitation in severe cases can be a slow process, but people often improve even two years after a stroke while some recover almost immediately.

Ms Nurazlinda Abdul Latiff, a physiotherapist who specialises in stroke rehabilitation at the National University Hospital, says recovery depends on how active the person was before the stroke occurred and their level of motivation.

She said rehabilitation is most effective when it is done intensively in the first month after the stroke, provided the patient is medically stable.

'This would mean four hours of therapy divided into two hours twice a day,' she said.

The programme includes physiotherapy to strengthen muscles and coordination and occupational therapy to relearn daily living tasks.

There are different levels of stroke rehabilitation in Singapore, starting with acute rehabilitation services in hospitals, step-down care, day rehabilitation centres in community hospitals and home-based therapy.

At TTSH's tertiary rehabilitation centre in Ang Mo Kio Hospital,a multidisciplinary team provides up to three hours of therapy a day. The centre has a sophisticated machine to assess a patient's balance and coordination, pinpoint the problem areas and help refine the measures taken.

Dr Kong said advances in robotics will further refine rehabilitation techniques. But traditional Chinese medicine and acupuncture can also play a role in stroke rehabilitation.

For many stroke patients, motivation is key in how well they do. Depressed patients may be given mild medication to boost their morale.

Ms Latiff encourages patients by charting weekly improvements in strength and stamina.

'Ultimately, even the person with a severe case of stroke can benefit from rehabilitation,' she said.