NeuroRecovery & Pain Treatment

NeuroRehabilitation in Istanbul: A Guide for International Patients and Families

Medically reviewed by Prof. Dr. Engin Çakar, specialist in Physical Medicine and Rehabilitation, Algology (Pain Medicine) and Electrodiagnostic Neurology · Updated

This guide is for patients and families considering neurorehabilitation in Istanbul after stroke, brain haemorrhage, brain injury, spinal cord injury or other neurological conditions. It explains what happens before travel, during the stay and after returning home.

Who this is for

Further reading: the guide “Neurological Diseases” and the articles Stroke Rehabilitation: Ischaemic and Haemorrhagic Stroke and Traumatic Brain Injury and Head Trauma: Symptoms and Rehabilitation.

Before travel: sharing reports and imaging

A review of existing documents helps decide whether rehabilitation is suitable, when to travel and what to expect:

  • Recent discharge summary and medication list
  • MRI/CT reports and, ideally, the image files
  • Details of tracheostomy, PEG, catheter or pressure injuries
  • Recent blood tests and infection status

Patients coming directly from intensive care should also read From intensive care to rehabilitation.

First examination and the individual plan

On arrival, a physical medicine and rehabilitation specialist examines the patient, reviews the records and sets goals together with the patient and family. Guidelines recommend that rehabilitation be goal-oriented, multidisciplinary and of sufficient intensity [1, 2].

What a rehabilitation day looks like

A typical day may include physiotherapy, occupational therapy, speech and swallowing therapy, cognitive therapy and, where suitable, robot-assisted gait or arm training (Robotic rehabilitation), with rest periods and medical rounds.

Length of stay: how it is decided

Length of stay is not fixed in advance as a package. It depends on the condition, goals, progress and medical needs, and is reviewed regularly with the family.

Language and family involvement

Language needs can be discussed in advance; depending on the language, interpreter support may be possible. Families are involved in goal setting and are trained in safe transfers, exercises and care before discharge.

Follow-up after returning home

Before discharge, a written summary and home exercise programme are provided. Where possible, follow-up options, such as coordination with the local team, can be discussed before discharge.

Is the patient medically ready to travel?

Travel is considered only when the patient is medically stable. Points that are usually checked include stable breathing and oxygen needs, blood pressure and heart rhythm, infection status, wound and pressure-injury care, and the risk of blood clots (deep vein thrombosis) during a long journey. The treating team at home and the airline may also need to confirm fitness to fly, and some patients need a medical escort or special seating.

Who decides on the programme

After acute care, the rehabilitation process is best led by a physical medicine and rehabilitation (PM&R) physician. Suitability for robotic or other advanced therapies is decided by a PM&R specialist focused on neurorehabilitation. Prof. Dr. Engin Çakar works in this field and can be consulted online or in person; an online review of reports before travel can help clarify expectations. The daily programme is then carried out by your physical medicine and rehabilitation specialist and the physiotherapist, together with the wider team.

Practical points for families

  • Plan for a family member or caregiver to accompany the patient, as their involvement and training support the transition home.
  • Bring enough regular medicines, with a written list of names and doses.
  • Bring comfortable clothing, supportive shoes and any orthoses (braces) or aids the patient already uses.
  • Keep copies of all reports, both printed and digital.

Preparing the home before return

Arrange a safe home environment before the journey back: clear walkways, grab bars, a shower chair, suitable bed height and, if needed, a wheelchair or walking aid. Ask for any equipment recommendations in writing.

When to consult a PM&R specialist after returning

At home, consult a local PM&R specialist for ongoing care, and seek review if progress stalls, new pain, spasticity (muscle stiffness), skin problems or falls appear.

Frequently asked questions

How early can a patient travel after a stroke? This depends on medical stability and the treating team’s assessment. Records can be reviewed first to discuss timing.

Can we get an opinion before travelling? Yes. You can request a second-opinion review of reports and imaging before making plans.

Is rehabilitation suitable for long-standing conditions? Functional gains are still possible in the chronic phase for many patients. Suitability is assessed individually.

Do family members need to stay? A family member’s presence is often helpful for training and support. This can be discussed in advance.

Can an online consultation replace the first examination? No. An online review helps assess documents and expectations, but the plan is finalised after an in-person examination.

Is rehabilitation suitable for everyone who wants to travel? Not always. If the medical condition makes travel unsafe or rehabilitation unlikely to help at that stage, this is discussed openly.

Assessment and contact

You can request an appointment or a second-opinion review of existing reports and imaging: Contact & second opinion (WhatsApp). This page is general health information. Diagnosis and treatment decisions are made individually after examination.

Sources

  1. Winstein CJ, et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016. PMID: 27145936
  2. Turner-Stokes L, et al. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database Syst Rev. 2015. PMID: 26694853