From 24 hours after a stroke, with your therapists’ help, you can try to help your recovery by starting to get moving. Recovery tends to be fastest in the first few weeks and months after a stroke, but it can continue for years. Everyone is different and there is no fixed time for recovery.
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What help is there for balance problems?
1) Physiotherapy
A physiotherapist can assess you. They can recommend activities or exercises that may help improve your balance. You should see a physiotherapist while you are in hospital. If you have left hospital, your GP can refer you for physiotherapy.
Private physiotherapists and some NHS services will accept a self-referral where you can go to them directly to request assessment and treatment. Our physiotherapy webpage has more information.
2) Balance retraining exercises
A physiotherapist might give balance re-training exercises. They will work with you to find out what you find difficult and set activities and exercises to help you improve your balance. These will become gradually more challenging to help you improve.
The exercises may start while sitting and then progress to standing and walking, perhaps with the help of equipment or the support of other people. Other activities might include:
- moving past obstacles
- changing direction and speed
- walking up stairs.
You’ll only be asked to do these when the therapist thinks it’s safe for you.
Sessions may take place in hospital with a physiotherapist or rehabilitation support worker, either one-to-one or in a group. You can carry on by practising yourself or with support from family or friends. After you’ve left hospital, some of your rehabilitation may be offered online or in person, in one-to-one or group sessions.
Sometimes, people feel worried about falling while practising balance exercises. If you’re concerned, ask your therapist for advice.
3) Activity and fitness groups
Some stroke support groups and other community groups run exercise classes or other services to help people with disabilities stay active. Group activities might take place in person or online. Classes such as tai chi might help improve balance for some people, but always speak to the instructor about your abilities before you start a new class. See our getting active webpages for more ideas about staying active.
4) Vestibular exercises
Vestibular training focuses on improving balance and reducing dizziness by retraining the brain to adapt to changes in movement and head position.
The vestibular system helps control balance and spatial orientation (understanding where you and other objects are positioned in relation to your surroundings, for example, knowing how close you are to furniture). The vestibular system can be affected after a stroke, leading to unsteadiness, vertigo (a spinning sensation) or disorientation.
You may be referred to a specialist if you need vestibular rehabilitation. Vestibular exercises may include head and eye movements, balance challenges and walking tasks that gradually increase in complexity. These activities help the brain relearn how to process sensory signals from the inner ear, eyes and body. This can help improve your overall balance, coordination and confidence while moving.
5) Equipment
A walking stick or walking frame can improve your balance and your confidence. It’s important the equipment is the correct size for you, so get professional help when choosing.
If you have foot drop (difficulty lifting your foot and toes off the ground when walking) you may be offered an ankle-foot orthosis (AFO). Our foot drop page has more information on AFOs and other treatments.
Help to prevent falls after a stroke
Many people tell us they feel worried about having a fall after a stroke. Support is available to help you reduce your risk of a fall and feel more confident getting around. You should be offered a falls risk assessment and support as part of your stroke rehabilitation.
If you’ve left hospital, your GP can give you advice if you’ve had a fall or are worried about falling and may refer you for help. A physiotherapist can also give you individual advice, including about what to do if you have a fall.
Some areas offer a falls prevention service to support people at risk of a fall. The way services run varies, but they all offer advice on how to prevent falls and injuries.
They can help you address issues, including:
- Any other conditions you have which may increase your risk of a fall.
- Reviewing your medication.
- Vision problems.
- Footcare and the importance of appropriate footwear.
- Your home environment, to see if there is anything that increases your risk of a fall or if home adaptations may help.
- They may also offer exercises to strengthen your legs and improve your balance.
In some areas, you may be able to self-refer to a falls service. Check with your GP surgery or see the NHS website for more information.
Tips to avoid a fall
When moving around
- Try to avoid doing two things at once, such as walking and talking on the phone.
- Move at a speed you find comfortable. Do not rush to do things more quickly. And focus on your movements when you do anything tricky. This includes turning, going up and down stairs, or getting in and out of the bath or bed.
- If you feel dizzy when you first stand up, hold onto something and wait for the dizziness to pass before you go anywhere.
Your home environment
- Organise your home so you’re less likely to bump into things. Remove clutter. Arrange furniture so you do not have to walk around it. Keep items you use the most in cupboards which are easy to reach.
- Keep floors clear of trailing wires, loose rugs, frayed carpets or anything else you might trip on.
- Mop up any spills straight away.
- Use high-wattage light bulbs so you can see clearly, particularly around stairs. If you get up in the night, turn the light on.
- Keep your home warm. Cold muscles work less well and this can affect your balance.
- Ask an occupational therapist about getting equipment such as hand-rails for the stairs and bathroom. Your GP can refer you to an occupational therapist. Also, use any walking aids, such as sticks or frames your therapist has provided
- Consider getting a personal alarm which can call for help if you have a fall.
- Ask for help with tasks you cannot carry out safely, or leave them if they are less important.
Looking after yourself
- Wear well-fitting shoes or slippers with thin soles, high sides and a good grip. Never walk on slippery floors in socks or tights. Avoid wearing loose, trailing clothes which could trip you up.
- Talk to a podiatrist (also called a chiropodist) about any foot problems. These can increase the risk of falls if left untreated. Your GP may be able to refer you to a podiatrist or some services may accept self-referrals.
- Try to keep physically active, as not moving around for long periods can affect your balance.
- Eating well and drinking enough can stop you feeling light-headed, which can also affect your balance.
- Have regular eye tests and wear any glasses prescribed for you.