Balance exercises are important in helping prevent falls and improving mobility. For individuals who have experienced moderate to severe strokes, the loss of sitting balance is a common effect that occurs and often needs to be addressed early in the stroke rehabilitation process. The ability to maintain balance while seated serves as a fundamental requirement for engaging in essential activities of daily living, such as dressing, bathing, and toileting. One cannot learn to stand safely until sitting balance is maintained first.
The exercises below are examples of how to improve sitting and standing balance. However, it is imperative that you consult with your physician or therapist to ensure these exercises are both safe and suitable for your specific circumstances.
Shift weight over the right hip then the left hip. Ribcage should move side to side and hip should lift off of surface. Don't bend at the waist to lean. Repeat the movement side to side. Books are placed under the hands while sitting to allow weight bearing through arms and to keep the hands from coming up off the sitting surface.
Shift your weight forward and back by arching and rounding your low back. Repeat the movement shifting your weight forward and back.
Lean down on to right elbow then push back up to center. Lean down on left elbow then push back up to center. Repeat as able.
Reach your non-affected arm out towards the weak side while bearing weight through the weak or paralyzed arm. If the weak arm buckles or the hand slides, have a helper support the weak arm at the wrist and just above the elbow. You can also try reaching in various directions while weight bearing on the affected arm.
Clasp hands together and reach forward then sit back up straight. Sometimes it helps to put a target in front of you to touch. Repeat movement touching target as then sitting back up straight as able.
Standing exercises should be done with a therapist or trained caregiver when the patient has unstable standing balance. Holding to a chair or counter or having a chair behind the patient may also be needed for safety. Patients should always check with their PT or OT to see what balance exercises are appropriate for their situation.
Clasp hands together and reach forward lifting bottom off of sitting surface then coming to full stand if able. If unable to do full stand, a partial stand is acceptable. Return to seated position then repeat as able.
While standing in place, shift your weight to the right and then to the left.
While in a standing position and knees partially bent, slowly shift your body weight forward and then back.
Place one foot in front of the other with feet slightly apart. Maintain your balance while standing.
These are just a few starting balance exercises. There are many other exercises that can be done to advance your balance. Check with your therapist for a balance home exercise program.
Research in the field of neuroplasticity has demonstrated that numerous repetitions of an activity should be performed over an extended period to "relearn" movement patterns. Since balance exercises can be physically demanding, particularly for individuals with limited trunk control, it is advised to start gently at first with fewer repetitions if needed.
Over time, gradually increase the number of repetitions you perform, ensuring you do so within your capacity without risking injury, muscle strain, or discomfort. Should you find a particular exercise too simple or easy, challenge yourself by attempting more advanced exercises. However, only do so in a safe environment and under the recommendation of your medical doctor or rehabilitation therapist.
When engaging in any balance activities after stroke, it is highly recommended to have the presence of a therapist or a trained caregiver to assist you, minimizing the risk of falls.
For further information and answers to questions about balance problems, visit https://www.stroke-rehab.com/balance-problems.html or visit https://www.stroke.org.uk/sites/default/files/user_profile /balance_problems_after_stroke.pdf for some great information on balance including how your balance can be affected after stroke and tips to avoid falling.
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