Exercise After Stroke: Regaining Strength, Balance, and Confidence

A stroke can affect nearly every part of a person’s life, from movement and balance to confidence, energy and independence. While recovery can feel challenging, regular exercise and physical activity are some of the most effective tools for improving recovery and supporting long-term health after stroke.

At Northside Allied Health, we help stroke survivors safely rebuild strength, mobility, fitness and confidence through tailored exercise programs designed around each individual’s needs and goals.

What Is a Stroke?

A stroke occurs when the blood supply to part of the brain is suddenly interrupted. Without normal blood flow, brain cells are deprived of oxygen and nutrients, which can lead to temporary or permanent damage.

There are two main types of stroke:

1. Ischaemic stroke — caused by a blockage or clot in a blood vessel supplying the brain. This accounts for around 80% of strokes.

2. Haemorrhagic stroke — caused by bleeding in or around the brain due to a ruptured blood vessel. Stroke symptoms can vary greatly depending on the area of the brain affected.

Symptoms may include:

• Weakness or numbness on one side of the body

• Difficulty walking or loss of balance

• Dizziness or fatigue

• Difficulty speaking or understanding language

• Changes in memory or thinking

• Blurred or reduced vision Difficulty swallowing

  
  

Some people may also experience a Transient Ischaemic Attack (TIA), sometimes called a “mini stroke”, where symptoms resolve within 24 hours. Even though symptoms improve, a TIA should never be ignored, as it can be an important warning sign for future stroke risk.

Recovery after stroke differs for every person. Some people recover quickly, while others may continue improving over months or years.

How Does Exercise Help After a Stroke?

Research shows that physical activity levels are often very low after stroke. However, regular exercise can significantly improve recovery while also reducing the risk of future strokes and other health complications.

Exercise can help improve:

• Walking ability and mobility

• Strength, fitness, and endurance

• Balance and coordination

• Flexibility and movement confidence

• Ability to complete daily activities

• Return to hobbies and leisure activities

• Mood and mental wellbeing

• Alertness and thinking ability

• Blood pressure and cholesterol levels

Exercise may also help reduce post-stroke fatigue, which is one of the most common barriers to being active.

Importantly, exercise is beneficial at every stage of recovery and doing something is always better than doing nothing.

Finding the Right Exercise After Stroke

There is no single “best” exercise program for people after stroke.

The most effective approach depends on:

• Current mobility and physical ability

• Severity of symptoms

• Other health conditions

• Personal goals and preferences

• Confidence levels and support systems

For many people, starting with light-intensity activity “little and often” is the best approach. Breaking up long periods of sitting and reducing sedentary time is also very important. The key is finding exercise that feels achievable, enjoyable, and sustainable.

Aerobic Exercise and Cardiovascular Fitness

Aerobic exercise helps improve heart health, endurance, energy levels, and walking capacity.

Suitable activities may include:

• Walking programs

• Treadmill walking

• Stationary cycling

• Elliptical trainers

• Stair climbing

• Group exercise classes

• Functional exercises such as sit-to-stands and stair practice

Most stroke survivors are encouraged to aim for aerobic exercise:

• 3–5 days per week

• 20–60 minutes per session

• Starting at a light intensity and gradually progressing over time

A simple way to monitor intensity is using a scale out of 10:

• Light intensity: 1–2/10

• Moderate intensity: 3–5/10

• Higher intensity: 6–7/10 (for those ready and medically appropriate)

Short sessions throughout the day can still provide excellent benefits. Exercise effects are cumulative, meaning every bit of movement counts.

Using activity trackers such as Fitbits or pedometers can also help monitor progress, increase motivation, and support goal setting.

Strength Training After Stroke

Strength training plays an important role in rebuilding muscle, improving mobility, and supporting everyday function.

Exercises may include:

• Resistance bands

• Free weights

• Machine weights

• Body-weight exercises

• Weight-bearing activities

• Functional strengthening movements

Strength exercises are generally recommended:

• 2–3 days per week

• With gradual progression over time

Programs should always be tailored to the individual’s current ability and recovery goals.

Balance and Coordination Training

Balance difficulties are common after stroke and can increase the risk of falls and loss of confidence. Specific balance training can help improve stability, coordination, and safety during movement.

Balance-focused activities may include:

• Walking practice

• Stepping over obstacles

• Stair and slope training

• Tai Chi

• Active gaming or coordination activities

Even simple daily tasks can become opportunities to practise balance and movement skills safely.

Overcoming Barriers to Exercise

Many stroke survivors face challenges that make exercise feel difficult, including:

• Fatigue

• Physical limitations

• Reduced confidence

• Changes in memory or concentration

• Low mood or anxiety

• Financial barriers

• Lack of support

The encouraging news is that exercise itself can often help improve many of these barriers over time.

Working with an experienced Exercise Physiologist can provide structure, support, and guidance to help people exercise safely and confidently.

How an Accredited Exercise Physiologist Can Help

An Accredited Exercise Physiologist (AEP) specialises in using exercise to support people living with chronic health conditions, injuries and disabilities, including stroke recovery.

At Northside Allied Health, we provide personalised exercise programs designed to:

• Improve mobility and physical function

• Build strength and endurance

• Improve balance and reduce falls risk

• Increase confidence with movement

• Support independence and quality of life

• Help people safely return to meaningful activities

For people with more significant movement difficulties, referral to a Neurological Physiotherapist may also be recommended.

Top Tips for Staying Active After Stroke

• Start small and build gradually

• Choose activities you enjoy

• Make exercise part of your routine

• Exercise with family or friends when possible

• Break up long periods of sitting

• Set realistic goals and celebrate progress

• Focus on consistency rather than perfection

Is Exercise Safe After a Stroke?

For most people, exercise is safe and highly beneficial after stroke. Before beginning a cardiovascular or structured exercise program, it is recommended to speak with your doctor or healthcare team to ensure activities are appropriate for your individual circumstances.

With the right support and guidance, exercise can be a powerful part of stroke recovery, helping people regain strength, balance, confidence, and independence.