Movement and balance

One of the most common physical symptoms of stroke is muscle weakness on one side of the body. This varies from person to person depending on the type, location and severity of the stroke.

Many people also have problems with balance post-stroke. As you move around, your brain uses information from your eyes and your inner ear’s balance system to keep you stable. It does this while also controlling your muscles and movement. However, a stroke can affect how information is processed in the brain, so you may feel unsteady or uncoordinated.

Your therapists will give you advice and exercises to help you re-train your balance system and get back as much muscle strength as possible.

Why am I unsteady?

Weakness

A stroke can cause weakness in your muscles, such as those in your arm, hand, torso, leg or foot. This can make all movement more difficult, especially just after your stroke. Your physiotherapist and occupational therapist will give you exercises to help you regain muscle strength. They will also work to help you get as much movement back into your arm or leg as possible.
If you still have some weakness in your arm or leg after your hospital and rehab stay, you may need adaptive equipment. This will help you and your family/carers with your movements and transfers. Your therapy team will guide you on this.

Loss of sensation

You may experience some changes to sensation in your arm or leg after a stroke. If these changes persist in your leg and foot, it can make walking quite difficult. You may not be able to feel your foot on the floor when you are stepping, for example. You can compensate for this a little by relying on extra help from your eyes, but this can be tiring and requires a lot of concentration. Your therapist will advise you on the safest way for you to move around.

Coordination

A stroke can cause coordination difficulties in your arm or leg. This is known as “ataxia” and can make movement more difficult. Your arms or legs can be “shaky” and difficult to control. For example, your foot might not go where you want it to when you are stepping, which can make you feel unsteady. Your physiotherapist can provide you with exercises to help with this.

Balance

A stroke can happen anywhere in the brain. Sometimes, it happens in the brain’s balance centre. This can leave you feeling very unsteady, dizzy and unsure when walking, even if your muscles are strong. Your physiotherapist may give you an aid to help you get back on your feet during the early stages of your recovery. They will also show you balance exercises that will help improve your balance and walking.

Other causes of movement and balance difficulties include:

• neglect (inattention) - where your brain pays less attention to one side of your body.​
• changes to your vision
• changes to your concentration
• perceptual changes – changes to how you interpret information from your senses
  
  

These can increase your risk of having a fall. Sometimes, changes to your medication, particularly your blood pressure medication, can make you feel a little unsteady or lightheaded. If this is the case, please call your GP or stroke team.

If you have had a very mild stroke or TIA and don’t have any of the above symptoms, you may still feel a bit off and unsteady after being in hospital for a few days. If this is the case, follow the advice in the “Moving more” page of this website. Start off gradually, and try to become more active each day.

Tips to prevent falls

1. Keep active to maintain good balance and strength.
2. Use a walking aid if you have been advised to do so by your physiotherapist.
3. Wear well-fitting, low, broad-heeled footwear with a non-slip sole. Avoid shoes or slippers with no back.
4. Make sure you have enough space to walk around your furniture, especially if using an aid. It is a good idea to remove rugs, mats and any loose cables, as they can be trip hazards.
5. Wear your glasses if you need them.
6. Have living areas and stairs well lit. Have a lamp at your bedside that you can switch on if you need to get up in the middle of the night.
7. Arrange things so you don’t have to bend, lift and reach too much. In the kitchen, leave out the items you use regularly, such as cutlery, and have them at level that is comfortable for you.
8. Don’t ever rush to answer the door or phone. The person who is waiting would rather you take your time and stay steady.
9. Avoid carrying anything with two hands on the stairs, such as a tray or walking aid. Use the bannisters.
10. Carry your mobile phone or pendant alarm with you around the house. If you do fall, you will be able to call someone for help.

Preventing falls

Other information

Frequently asked questions

Related pages