Mr Grunow is in a hurry this morning. The nursing service, here to help him care for his wife, came later than expected. Usually that's not a problem. The couple is now retired and the days when they needed to be punctual are long past.

It was different during their working lives. Both of them had a demanding job which kept them busy and gave them little time for each other. The couple had made preparations for the sudden disappearance of this pillar of stability in their lives – they didn't want their well-deserved retirement to end in boredom. Together they had decided to travel the world once more.

When they boarded the Orient Express three years ago to travel from Paris to Istanbul, on their way to discover Europe's most fascinating metropolises, it was like a dream come true. They had been enamoured with the nostalgic long-distance train since long before the film adaptation of Agatha Christie's "Murder on the Orient Express" reached the silver screen.

The journey began, as Mr Grunow recalls, on a sunny day in late summer. When they had boarded the train's gold-lettered carriages in Paris that afternoon, his wife had still felt as fit as a fiddle. Everything seemed to be going just as they had long envisioned it. Who could have guessed that Mrs Grunow's journey would end shortly afterwards on the threshold between life and death?

After a wonderful dinner in one of the train's elaborately restored dining cars, decorated with Lalique reliefs, the two retired to their compartment for the night at the end of their first day of travel. They talked and laughed a little longer, and the only danger they thought they had to fear that night was a restless sleep after eating so much at the evening's sumptuous dinner.

It must have been in the early hours of the morning when Mrs Grunow suddenly awoke with a terrible headache. When she turned on the light, she was overwhelmed by dizziness. She closed her eyes, fell back into the bed and lost consciousness shortly afterwards. When she regained consciousness, her life had abruptly changed. The right side of her body was as heavy as lead. She was shocked to find that she had completely lost control of her limbs. When, shortly afterwards, two paramedics pushed her in a wheelchair through the station to the waiting ambulance, she was already starting to fear that she would never recover. Mr Grunow had arranged for the train to stop at the nearest station after noticing in the morning that something was clearly wrong with his wife.

At the hospital, the doctors explained to them that a blood clot had blocked one of the important brain-supplying arteries in Mrs Grunow's head. The nerve tissue of her left brain had therefore been deprived of oxygen for an extended period, and had been destroyed. Mrs Grunow had suffered a stroke. The brain areas responsible for movement control were particularly affected. The right side of her body was completely paralysed, and this also caused the corner of her mouth to sag, as if fixed in an expression of grief and resignation. But what she felt inside couldn't have been more different – she was more determined than ever. The more Mrs Grunow found herself relying on the care of others, the stronger her ambition to win back her old life became. The next few months taught her just how laborious the way back into society was to become for her. Many times, she might have preferred simply to give up, had her husband not been there to keep inspiring her with new courage.

Unlike most cells in the human body, the brain is unable to heal itself. Mrs Grunow had to accept that the functions located in the damaged part of her brain had been erased. Her fate was more or less in her own hands. It was only through intensive training, she had been told, that she could ensure that her condition would gradually improve again. For weeks, she put all her efforts into rehabilitation. She underwent countless treatments in which she tried, by way of targeted movement exercises, to stimulate intact nerve cells in her brain to take over the tasks of destroyed brain areas and to return to her paralysed limbs at least a part of their original function. The clinic even employed a gait robot to help her get closer, step by step, to her ultimate goal of independent walking.

Even today, three years after the acute stroke, the paralysis in the right half of her body has not completely disappeared. However, thanks to the intensive therapy and with the support of her husband, Mrs Grunow can take a few steps around her apartment. But most of her life is still tied to the wheelchair. Her resolve to get back on her feet remains unbroken. The agonising feeling of only existing on the fringes of society, and no longer being part of it, spurs her on to something new each and every day. But this does not make the fight to find funding for further therapies any easier for her. As a chronic stroke patient, Mrs Grunow is often treated as if she will never be able to return to a normal life, and the progress she has been making has indeed diminished. But it is still there, and still measurable. Mrs Grunow meticulously keeps a therapy diary. Every day she trains with a movement exerciser, which she can now operate herself, and which helps her to avoid muscle loss and restricted movement in her limbs. In addition, she has physiotherapy and occupational therapy sessions several times a week.

Therapy is also the reason why everything needs to happen faster than usual this morning. After a lengthy dispute with her health insurance company, Mrs Grunow finally received approval for a long-awaited intensive therapy a few weeks ago. Not in a rehabilitation clinic, but in an outpatient therapy practice specialising in the treatment of stroke patients. Mrs Grunow's main goal is still to improve her ability to walk. Thanks to a special exercise program, which consists of modern robot-assisted therapy methods and intensive training focused on the challenges of daily living, there is now hope of getting even closer to that goal.

The conventional therapy that Mrs Grunow usually receives had lately been limited to short exercise sequences, mainly performed while sitting down, which had not improved her walking ability in the last few months. The intensive stroke rehabilitation programme is quite different. Mrs Grunow's agenda now contains daily gait training at the limit of her performance. As the therapist explained to her during the consultation, "walking is practised by walking". This is confirmed by scientific studies. Another exciting aspect is that Mrs Grunow isn't simply treated on her own. The exercise programme takes place three to five days a week, and consists entirely of group sessions. Mrs Grunow was sceptical at first, but now she is enthusiastic. The achievements of the other stroke patients training alongside her help to spur her on. She knows all too well how difficult it can be to overcome one's weaker self. Training in a group makes everything so much easier. In addition, the group members all know each other well by now, and the well-deserved breaks between individual treatment sequences give them an opportunity to share their experiences.

After only two weeks of intensive therapy, Mrs Grunow has already made a great achievement on her way towards her goal. She walked a proud ten metres through the clinic without any help at all. Only her therapist accompanied her as a "guardian angel", while her fellow patients, the rest of the team of therapists and her husband – who is always at her side – clapped and cheered her on. Mrs. Grunow's motto ever since has been: one more step every day!

At a glance Summarised

1. After severe headaches, dizziness and unconsciousness, the patient is found to have suffered a stroke.

2. Despite her struggles, she does not lose her ambition to regain her old life and trains with a movement exerciser to avoid muscle loss and movement restrictions. She is enthusiastic about the intensive group training.

3. Even years after a stroke, patients can still achieve motor improvements.