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Core Exercises for Stroke Patients: 15 Ways to Improve Trunk Control, Gait, & Balance

survivors performing core exercises for stroke recovery

Core exercises for stroke patients help improve stability throughout the body, which helps improve balance and gait (your manner of walking). Building core strength and coordination through trunk control exercises can also help reduce your risk of falling and prevent further injury or complications.

It’s important to find core exercises that are safe and suitable for your level of ability. To help you get started, we’ve compiled a list of the most effective core exercises for stroke patients. Use the links below to jump straight to any section of this article.

Why Core Strength Matters During Stroke Recovery

Core exercises are essential for improving balance and stability throughout the body. This allows us to not only stay balanced while we sit or stand, but also to maintain our balance while we walk. To understand how this works, let’s look at how a stroke impacts movement in the body.

Each hemisphere of the brain controls movement on the opposite side of the body. When a stroke damages the areas of the brain that control movement, it can result in motor difficulties on the right or left side of the body referred to as hemiparesis.

When one side of the body is impaired, but the other side is not, it can create difficulty with balance and even impair your gait. Fortunately, stroke rehabilitation exercises can help rebuild strength and coordination throughout the body, including the core, via neuroplasticity.

Neuroplasticity refers to the brain’s ability to rewire itself and heal after an injury such as a stroke. As neural connections are created and strengthened, communication between the brain and the affected muscles is improved. This leads to better trunk control, dynamic balance, standing balance, posture, and gait.

To activate neuroplasticity, it’s essential to practice high repetition of core rehab exercises. The more a movement is practiced, the more the brain will reinforce the neural connections for that movement. This is how physical functions, including core stability, are restored after a stroke.

Effective Core Exercises for Stroke Patients

To help you rebuild core strength and coordination after stroke, we’ve gathered 15 effective core exercises that you can do at home. It’s important to work closely with your therapist to adjust these stroke exercises to your level of ability and make sure they are safe for you.

Before we get started, here’s a video from Flint Rehab that walks you through some beginner-level core exercises for stroke patients. If you have limited mobility, this is a great starting place. If you have a high level of existing mobility, you can use this video as a warm up.

Following along with a rehabilitation exercise video can be helpful to stay focused. However, some may prefer written versions of the exercises. We’ve included these below.

1. Back Extensor Isometric Hold

Back isometric hold exercise.
Continuation of a back extensor isometric hold exercise.

Sit at the edge of a seat and lean back against the chair. Hold this position for a few seconds or as long as you can. Then, use your core muscles to sit up straight and return to your starting position. Repeat 15 times.

2. Trunk Rotation (Twists)

Trunk rotation core exercise for stroke patients.

For this core exercise, begin by placing your right hand on the outside of your left thigh. With your back straight, use your arm to help twist your torso to the left. You can use your unaffected hand for assistance. Be sure to keep your spine straight and stop twisting if you feel any pain. Then, return to the initial position. Complete this trunk rotation 15 times in each direction.

3. Lateral Trunk Flexion (Oblique Crunches)

Lateral trunk flexion core exercises after stroke.

Begin this trunk control exercise in a seated position. Dip your left shoulder down towards your left hip and then return to an upright position, focusing on using your core muscles to pull yourself up. If needed, you can use your arm to help push you back up. Repeat this seated core exercise on each side 15 times.

4. Seated Trunk Extension

Seated trunk extension exercise.

Keep your back straight while sitting at the edge of your seat. Slowly, lean forward without falling over. Then, engage your core muscles to lean back until you tap the back of your seat. You may use your arms for an added boost. Hold for about 5 seconds, or as long as you can, and then return to an upright position. Repeat 15 times.

5. Trunk Circles

Starting in a seated position, slowly lean forward. Then, slowly rotate your trunk clockwise, keeping your core muscles engaged. The larger the circles you make, the more challenging this exercise becomes. Complete this 15 times, rotating in both clockwise and counterclockwise directions.

Intermediate Core Exercises for Stroke Patients

After mastering the exercises included in the video above, you may be ready to complete some more challenging core strengthening exercises. Some of these may be more difficult if you have trouble with your seated balance. Always have someone nearby the first time you are attempting these core strengthening exercises to ensure that you are able to complete them safely.

6. Forward and Lateral Punches

Forward punches trunk control exercises.
Lateral core exercise for stroke survivors.

In a seated position, clasp your hands together and then punch forward. Use your trunk to lean forward while keeping your arms parallel to the floor. Go as far forward as you can safely without falling. Then, use your back muscles to come back up. To complete lateral punches, remain seated and interlace your fingers. Extend your arms in front of you with your elbows straight, then, lean to the right and “punch” the air. Return to center and repeat, completing 15 repetitions in each direction. Although you may feel pressure in your core, if you feel any pain in your back, stop immediately.

7. Seated Marches

Seated marching core exercise.
Seated marching core exercise for stroke patients with limited mobility.

Begin this exercise by sitting on the edge of a seat. Then, alternate lifting each leg and bringing the knees up. Focus on engaging your core throughout this exercise. For an added challenge, stand holding onto the back of your chair and complete marches in place.

8. Leg Rotations

Leg rotation exercise to strengthen the core.
Continuation of a leg rotation exercise.

For this core exercise, lie down on a mat with your knees bent at 90 degrees and feet flat on the floor. With control, let your knees fall to the right and gently rotate your truck to help lower your legs. Then lift your knees back up to the starting position and repeat on the other side. Complete 15 repetitions.

Throughout this exercise, focus on engaging your core and keep your low back flat against the floor the entire time. As soon as you feel your low back beginning to lift off the floor, stop rotating and return to the starting position.

9. Leg Raises

Illustration of a leg raise exercise.
Continuation of a leg raise exercise.

Similar to the leg rotation exercise, lie on your mat with your knees bent at 90 degrees and feet flat on the floor. Extend your leg until your knee is straight. Then, bend at the hip and lift your leg as far as you can safely, then bring it back down. Repeat 10 times on each side.

Advanced Core Exercises for Stroke Patients

The following exercises are advanced moves that should only be attempted once you have regained enough strength and coordination in your core. Ask your therapist if they are suitable for you, along with any extra tips for modification.

10. Bridges

Bridge core exercises.
Bridge core exercise for stroke patients.

For this trunk control exercise, lie on your back with both knees bent at a 90-degree angle. Use your core to scoop your glutes up, making sure not to sway to either side. Then, release your body back down and repeat 10 times. This exercise targets the core, glutes, and hamstrings to improve strength and stability throughout the body.

11. Crossbody Leg Lift

To perform this advanced core exercise, lie on the floor with your arms and legs flat. Then, lift your left foot and tap it with your right hand. Alternate with your right leg and left arm and repeat 10 times. If it is too challenging at first, you can lift and tap your elbow to the opposite knee.

12. Crunches

Therapist performing crunches.
Therapist illustrating how to do crunches.

Crunches are classic and challenging core exercises for stroke patients. While lying on your back with your knees bent at a 90-degree angle, place your hands on your thighs. Then, lift your core and slide your hands up to your knees, or as high as you can safely go. Then, release back down. Complete 30 crunches.

While performing this exercise, it’s important not to pull on your head or strain your neck. If you feel any pain, stop immediately. Instead, lift as high up as you can using your core muscles, and then release back down.

13. Toe Taps

Toe tap core exercise to improve balance.

While lying on your mat, assume a tabletop position by lifting your legs with your knees at a 90-degree angle. Your shins should be parallel to the floor and your core should be fully engaged. Then, from this position, bring one leg down and gently tap the floor with your foot.

Bring your leg back up by using your core muscles, keeping your knee bent at a 90-degree angle throughout the exercise. Alternate with the other leg, all while keeping your core as engaged as possible. Repeat this core exercise 15 times.

14. Kneeling Planks

To perform kneeling planks, start in a tabletop position on the floor. Then, move your knees back until your body forms a straight line from your head to your knees. Hold for 20 seconds or longer if you want more of a challenge. To reduce the intensity, you can move down to your forearms.

15. Knee to Chest

Knees to chest core exercise to promote movement after stroke.

This core exercise may be more challenging than others. Be sure to try it only if you’ve been cleared by your therapist. To perform this exercise, sit or lay in a comfortable position on your back. Then, hug your knees into your chest. Hold onto your left leg with your left arm and then extend your right leg onto the floor. This will be your starting position.

From your starting position, bring your right leg back into your chest. Try not to use your leg muscles to achieve this movement. Focus specifically on engaging your core and using your core muscles to lift your leg. Once your leg is back to your chest, repeat with the other leg, alternating on each side a total of 10 times.

Core exercises for stroke patients may vary in difficulty level. While they can all be beneficial, it’s important to find the appropriate trunk control exercises for your ability level. The goal of rehabilitation exercise is to feel challenged but not frustrated.

If these advanced core exercises are too hard, continue with the other exercises until you build up enough strength and coordination. While difficult exercises may seem better at first glance, you don’t want to injure yourself and, furthermore, what matters most to your recovery is repetition and consistency.

Practicing Trunk Control Exercises at Home

The best way to see results from your core exercises is to practice on a consistent basis at home. This will provide your brain with the stimulation it needs to rewire itself and improve control over your affected muscles.

While the core exercises provided in this post are helpful, it can be hard to follow along with them on a daily basis. While consistent exercise is the key to recovery, it’s important to do something extra for yourself to stay motivated to exercise at home. This is where interactive neurorehabilitation devices like the FitMi from Flint Rehab can help. It takes classic rehabilitation exercises, much like the ones in this article, and turns them into an interactive experience.

FitMi neurorehabilitation device that provides trunk control exercises.

As you follow along to the exercises on the screen, FitMi provides real-time feedback and unlocks more challenging exercises as you improve. It also allows you to target specific muscle groups including the hand, arm, legs, and core.

Completing rehabilitative exercises is a great way to get the repetitions needed to improve your core strength. However, as you continue to progress, you may be ready to try some more engaging activities that engage your core, such as swimming, yoga, or Pilates. These activities often include repetitive motions and can be more enjoyable than rote exercises. Always consult with your therapist before starting any new core strengthening activities to ensure that you are safe to do so.

Understanding Core Exercises for Stroke Patients

As previously mentioned, it can be challenging to stay motivated and practice core exercises at home after a stroke. Fortunately, with a combination of therapy resources, you can boost your motivation and achieve your goals more swiftly.

Core exercise are particularly helpful for improving balance and walking, two common challenges that many survivors face. You will see the best results by practicing your exercises with high repetition on a consistent basis.

We hope this article helped you understand the importance of retraining your core and provided plenty of places to start exercising.

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Get Inspired with This Stroke Survivor Story

Mom gets better every day!

“When my 84-year-old Mom had a stoke on May 2, the right side of her body was rendered useless. In the past six months, she has been blessed with a supportive medical team, therapy team, and family team that has worked together to gain remarkable results.

While she still struggles with her right side, she can walk (with assistance) and is beginning to get her right arm and hand more functional. We invested in the FitMi + MusicGlove + Tablet bundle for her at the beginning of August.

She lights up when we bring it out and enjoys using it for about 20 to 30 minutes at a time. While she still doesn’t have enough strength to perform some of the exercises, she rocks the ones she can do! Thanks for creating such powerful tools to help those of us caring for stroke patients. What you do really matters!”

-David H.

FitMi is a neurorehab device that you can use from the comfort of home. It works by motivating you to accomplish high repetition of therapeutic exercises.

As you work through the program, you’ll unlock more difficult exercises when you’re ready. It’s like having a virtual therapist available anytime you need it.

See how quickly Sudhir was able to notice improvements:

Saw results within a few days

“I bought FitMi about a month and a half ago. Quite impressed with the range of exercises for hand, arm, leg and foot. I suffered a stroke about 2 years ago which paralyzed my right side. I do walk now with a cane or walker, but my right hand curls up and my right arm is also weak. Within a few days of trying it out, I could note a distinct improvement in stamina before tiring. So, I am looking forward to continued improvement.”

-Sudhir

Not only is FitMi approved by survivors, but it’s also approved by therapists, too. FitMi is used in some of the top clinics in the world, including the Shirley Ryan Ability Lab, the #1 ranked rehab hospital in America. Plus, two PTs on YouTube with over 3 million subscribers (you may know them as Bob & Brad) gave FitMi the thumbs up, too.

To learn more about this motion-sensing, game-changing recovery tool, click the button below: