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Stroke Smart Magazine

January/February 2009

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Build Better Balance
Rewriting the Balance Blueprint

By David Dansereau

Balance, a task we mastered early in life, seems simple enough. But after a stroke, balance often needs to be relearned.

Think of how you first learned to ride a bike. In the beginning, your brain was overwhelmed by all the information it had to process: how fast to pedal, when to coast, how to steer, how to stop. Riding that bike at one time took all of your focus. However, with a lot of practice it eventually became automatic. With continued exposure to this new situation, you built a new blueprint in the brain for the nervous system to follow.

If you are trying to build better balance after a stroke, the nervous system must be challenged in order to rewrite your balance. The goal is to get the body and nervous system to rebuild this blueprint together.

Four quick tips for building balance

1. Have a written plan or calendar for building your balance. Know where you are now in your recovery and exactly where you want to be in “X” months. Record how long you can currently balance in different positions or any other benchmarks that will help motivate you.

2. Make balance training fun. Investigate video games such as Wii-Fit that can assess and train your balance. Consider getting back into sports or hobbies you once enjoyed.

3. Practice, practice, practice — but with purpose! Building better balance certainly requires more than performing two sets of 10 reps twice a day. Find little ways to sneak in more balance practice. Try to stand on one leg while brushing your teeth. Use the mirror to provide instant visual feedback of your progress.

4. Film your progress. Inexpensive webcams or home video cameras can help you measure your progress and see the before-and-after results of your balance training. You can also record your health and rehabilitation goals and replay them frequently to help keep you motivated.

David Dansereau, MSPT, is a physical therapist and nutritionist in private practice in Providence, R.I. He also is a stroke survivor. You can learn more about Dansereau by going to www.my-physicaltherapy-coach.com.


The ability to maintain balance involves effective communication and coordination between three sensory systems in the body:

1. Visual - position of your head in relation to your environment

2. Somatosensory - relative position of body parts

3. Vestibular - orientation of the head and speed of movement


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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.

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