Unfortunately, there’s little awareness of the procedures available to patients who’ve suffered a stroke. Typically, after a patient has undergone rehabilitation for a year, they’re determined to have achieved the ultimate function that they can achieve. Because of this, most patients are not receiving the surgical care that would help improve their quality of life. It is realistic that in most cases of heavy plegia surgical procedures can increase their functionality substantially. Improving walking, improving independence, improving the use of the hand and leg. The ultimate effect of these procedures is to ease the patient’s day to day life, self care, and ability to get about. Walking should be improved. The ability to use the hands, the ability to take care of yourself, feed yourself, and accomplish tasks of daily living should be eased. Sometimes it requires stepwise procedures, beginning with the leg moving to the arm and back and forth until we achieve the function that we’re after. Typically, a patient should be under the care of a reconstructive surgeon for up to three years from the initiation of these procedures until we achieve the ultimate desired result.