Building confidence in the way you move
Balance and mobility can change significantly after stroke. Rebuilding them can help you move more confidently around your home, outdoors and eventually towards the activities that matter to you.
Movement after stroke can feel different
Stroke can affect strength, sensation, coordination, vision, spatial awareness and balance.
You may feel unsteady when standing, find turning difficult, become less confident on uneven surfaces or notice that one side of your body doesn't respond in the way it did before.
For some people these difficulties improve considerably during rehabilitation. Others continue to work on balance and mobility over a much longer period.
Being able to stand, turn, reach, transfer and move confidently through everyday life matters too.
Balance is more than standing on one leg
Standing Balance
Maintaining a stable position while standing can be an important foundation for many everyday activities.
Moving Balance
Walking, turning and changing direction require your body to continually adjust while you're moving.
Everyday Balance
Reaching into a cupboard, getting dressed, stepping off a kerb or carrying something can all challenge balance.
When physiotherapy matters
Balance and mobility problems following stroke can have several different causes.
If your balance significantly affects your ability to move, you experience falls or near-falls, or you're struggling with walking and transfers, assessment by an appropriately trained physiotherapist can be particularly important.
A physiotherapist can assess how your stroke has affected movement and develop exercises or strategies relevant to your individual difficulties.
Falls shouldn't simply be accepted
If you're falling, regularly losing your balance or have experienced a significant deterioration in your mobility, seek appropriate professional assessment.
Don't make an exercise deliberately unstable simply because you've been told that instability improves balance.
Mobility is built from everyday movements
Sitting to Standing
Getting out of a chair combines strength, balance and coordination and is an important everyday movement.
Standing
Building confidence in a stable standing position may be an important step before progressing to more challenging movement.
Stepping
Controlled stepping forwards, backwards or sideways may form part of mobility training where appropriate.
Turning
Changing direction places different demands on balance than simply walking forwards.
Reaching
Reaching while sitting or standing changes your centre of gravity and is part of many daily tasks.
Walking
Walking combines repeated weight transfer, balance, strength and coordination.
Progressing balance gradually
Balance exercises don't need to begin with difficult or risky movements. Challenge can be introduced progressively according to your ability.
Start from a stable position
Begin with movements you can perform with an appropriate level of support and control.
Practise consistently
Repeating appropriate movement tasks can help build familiarity and confidence.
Increase the challenge gradually
Progress may involve changing the movement, reducing appropriate support or introducing a more demanding task.
Make it relevant to real life
Balance training becomes particularly useful when it supports the activities you actually want or need to perform.
Fear of falling can affect movement too
A fall — or even the fear of having one — can reduce confidence.
You may start avoiding stairs, outdoor walking, crowded places or situations where you don't feel completely stable.
That reaction is understandable, but avoiding movement altogether can make it harder to regain confidence.
The aim is not to ignore the risk. It is to find appropriately supported ways to keep moving forward.
Confidence can be trained too
Progress might initially mean standing without feeling anxious, walking a familiar route with someone beside you or practising a movement with appropriate support.
Small successes can gradually change how you feel about movement.
Balance and walking
Walking requires your body to repeatedly transfer weight from one side to the other while moving forwards.
As walking improves, different environments introduce new challenges: kerbs, uneven ground, slopes, crowds and changes of direction.
That's why becoming confident indoors doesn't necessarily mean outdoor walking will immediately feel the same.
WALKING AFTER STROKEBuild the environment too
A progression might eventually move from:
- Familiar indoor surfaces
- Level outdoor paths
- Longer routes
- Changes in direction
- Uneven surfaces
- Slopes or hills
Your own progression may be different.
Strength and balance work together
Balance isn't completely separate from strength.
The muscles of your legs and trunk contribute to controlling your body, standing, stepping and recovering your position during movement.
Lower-body strength
Appropriate strengthening may support movements such as standing, stepping and climbing stairs.
Trunk control
Controlling the position of your trunk can contribute to sitting, standing and movement.
Your environment matters
Mobility isn't only about what your body can do. Your surroundings can make movement easier or more difficult.
Loose rugs, clutter, poor lighting, awkward furniture and difficult stairs may create additional challenges.
Occupational therapists and other members of your rehabilitation team can advise on equipment and adaptations where these are needed.
Think about your surroundings
- Clear walking routes
- Good lighting
- Appropriate footwear
- Correctly prescribed walking aids
- Safe access to stairs
- Support where it is genuinely needed
Walking aids aren't a sign of failure
Some stroke survivors use a stick, frame, ankle-foot orthosis or another mobility aid.
Appropriate equipment can improve safety and independence. The aim shouldn't be to abandon an aid simply because walking without one appears more advanced.
Fatigue can change the way you move
You may notice that your walking, balance or coordination deteriorates when you're tired.
This makes it useful to think about how you move at the end of an activity as well as at the beginning.
Watch for changes
Pay attention to whether movement becomes noticeably less controlled as fatigue increases.
Plan recovery
Rest and pacing can form part of a sensible mobility strategy rather than being viewed as failure.
What does better mobility mean to you?
Moving around home
Becoming more confident with everyday movement and transfers.
Getting outdoors
Walking beyond the home and becoming more confident in the community.
Returning to activity
Building towards the gym, hobbies, longer walks or other physical goals.
The real goal is being able to participate more fully in the life that's important to you.
From rehabilitation towards an active life
Stroke Health Fitness isn't trying to replace neurological physiotherapy.
Physiotherapists play an important role in assessing and treating movement difficulties after stroke.
Our aim is to complement that professional support with practical information about continuing to become active, stronger and more confident over the longer term.
The journey can continue
Rehabilitation goals might begin with standing and walking.
Longer-term goals might eventually involve independent travel, gardening, the gym, swimming, hiking or returning to sport.
They're all part of movement.
Continue exploring
Responsible balance & mobility guidance
Balance and mobility difficulties after stroke can have different neurological and physical causes and may require individual assessment.
Stroke Health Fitness encourages appropriate involvement from physiotherapists, occupational therapists, doctors and other healthcare professionals where needed.
This page provides general educational information and is not a substitute for individual medical advice, physiotherapy, occupational therapy or rehabilitation.
Move towards what matters to you
Better mobility isn't about passing a test. It's about becoming more confident and capable in the places and activities that make up your life.