Walking After Stroke: 5 Gait Training Exercises To Improve Strength and Balance

A patient practices balancing as part of physical therapy

A significant goal in post-stroke rehabilitation is to regain the strength to walk independently. Your gait is your specific pattern of walking. Walking is a complex series of movements that requires your bones, muscles, and brain to work together, with help from your lungs and heart. When an individual has a problem with any of those symptoms, it is known as a gait disorder. Having a gait condition can affect your quality of life and put you at a greater risk for falls and injuries.

Gait training and balance training are key components of post-stroke rehab. It can help you relearn how to walk, improve your balance and coordination, and increase the strength of your ankles, knees, and hips to support your body when you move.

Some gait deviations observed in patients post-stroke include:

  • Decreased stride length
  • Decreased stance time on the weakened leg
  • Decreased standing balance and stability, especially while weight shifting
  • Decreased steps per minute

These challenges make it difficult for you to propel the body forward and can cause instability while walking, limiting your ability to bear weight through the weaker side of your body.

Some key muscle groups that can benefit from strength training to improve gait quality after a stroke include:

  • Hip flexors: to lift the leg to increase step length and foot clearance
  • Glutes: to extend the hip, increasing the force generated to propel the body forward, and to increase the stability of the pelvis, to support balance with weight shifting between each leg and changing directions
  • Quadriceps: to extend the knee, providing stability to the knee to improve weight bearing tolerance and to prevent knee buckling
  • Tibialis anterior: the motion of lifting the foot up toward the body to clear the foot from dragging and prevent tripping while taking a step

Post-stroke rehabilitation requires a high degree of motivation, engagement, and participation from the patient for good outcomes.

Balance and Strength Exercises for Improved Walking After a Stroke

1. Side-Stepping

Side stepping is a great way to increase glute activation and dynamic stability and balance with lateral weight shifting.

  • How to perform: Step to the side with one leg then follow with the other. Repeat several times, then change directions and repeat. Ensure that you are using support if needed.
  • Progression: Resistance bands can be added around your knees to increase glute activation while side-stepping. If possible, try not to rely on arm support to maintain your balance.

2. Forward to Backward Weight Shifting

Improve foot clearance, pelvis stability, and standing balance with weight shifting.

  • How to perform: Weight shift forward by taking a step forward with one foot, then lift your leg up and move it back behind your body to weight shift backward. Repeat several times, then switch sides. Always use support to ensure stability.
  • Progression: Adding ankle weights increases the difficulty. Challenge yourself by not relying on arm support to maintain your balance

3. Step-ups

Increase hip flexor strength. This improves foot clearance, step length, quadriceps, and glue strength for improved force generation and gait speed. It also improves pelvis stability and standing balance with weight shifting.

  • How to perform: Stand in front of a step. Step up with one foot followed by the other, then step down. Repeat several times.

Progression: Challenge yourself by not relying on arm support to maintain your balance. Increase step height for added difficulty.

A stroke patent practices stepping over objects with the help of a physical therapist.

4. Sit to Stand

Increase quadriceps and glute strength for improved stability and leg strength.

  • How to perform: Sit in a chair, lean forward, and use your legs to stand up. Slowly lower yourself into the chair with control. Try not to use your arms to help you up from the chair.
  • Progression: Resistance bands around your knees increase glute activation by pushing your legs out to make the movement more challenging.

5. Marching

Increase hip flexor strength to improve foot clearance, and increase single-leg strength and stability while standing and weight shifting.

  • How to perform: (Sitting) Begin seated in a chair. Lift one leg up, hold for two seconds, then lower. Repeat on the other side. If you are standing, use a stable object such as a chair or table for support, and slowly lift up your leg. Hold for two seconds then lower. Repeat on the other side.
  • Progression: Adding ankle weights in sitting or standing positions can increase difficulty. For standing marching, challenge yourself to try not to rely on arm support to maintain your balance.

Each of these exercises can help you gain strength and balance after suffering from a stroke. If you are in need of extra assistance, the Solo-Step overhead track and harness system is a great option to keep you safe during therapy. The Solo-Step safety overhead system allows you to:

  • Rehab without a gait belt
  • Eliminate the fear of falling
  • Gain confidence during physical therapy
  • Rehab without the possibility of falling down or getting injured
  • Challenge yourself with advanced therapies
A senior patient practices stepping up on a small box

To learn more about the Solo-Step fall protection system, click here!