Preventing falls after a stroke

walking with a crutch

Balance problems can reduce your confidence and increase your risk of falling. There are many different things that can cause balance problems after a stroke.

According to the NHS, around one third of adults over 65 and half of people over 80 will have at least one fall a year. Falls can cause injury. They can also impact your confidence and feelings of independence.

Many people struggle with balance problems after a stroke. This is because a stroke can change the way your brain controls balance. Balance problems can leave you feeling unsteady or uncoordinated.

Below is a short list of some common causes of balance problems in stroke survivors:

  • Weakness on one side of your body or foot drop
  • A loss of sensation in your leg or foot
  • Difficulty concentrating
  • Vision problems or vertigo
  • Medication side effects

This is not an exhaustive list. You can find more about the causes of balance problems here.

What to do if you have a fall

Knowing what to do if you have a fall can help you to feel more confident. The NHS has lots of advice on preventing falls and what to do if you fall. But here are some basic steps you can use as a starting point. If you are a family member, friend or carer of someone who’s had a stroke, you can also use these steps to talk someone through getting up off the floor if you can’t get to them immediately.

First, if you fall, try not to panic. Breathe deeply to help you to relax if you are shaken up or in shock. If you think you may be hurt, call for help and don’t attempt to get up.

1.) Roll onto your weaker side, or the side most affected by your stroke.

2.) Use your stronger arm to push yourself up into a sitting position.

3.) Move along on your bottom to a sturdy piece of furniture that you can use to help you up, such as a chair or bed.

4.) Position yourself sitting sideways with your stronger side closest to the furniture.

5.) Use your stronger arm to position yourself so you are kneeling with both knees on the floor. Put your arms on the furniture to support you as you kneel up.

6.) Lean your weight over your arms. Step your strongest leg forward so your foot is flat on the floor. Then push your hip up onto the furniture. Sit down and rest.

How to work towards this skill:

  • If you know you can already rise from the floor without concern, keep practising on a regular basis so you don't lose this skill!
  • If you’re not sure if you can get up from the floor you can try to improve your mobility with simple shoulder, trunk and hip exercises. Think about how you transfer, roll and get out of bed – these are similar movements

You may also want to talk to your physiotherapist as stroke survivor Keith talks about in this video.

"I dealt with it at home with the physiotherapist and the OT team...I happened to say to them one day I said, Look, I am absolutely terrified if I fall because I don't know how I will get up. So they actually took me through a routine of putting me on the floor and showing me how, first of all, how I can calm myself down, which is important because you've now hit the deck and how I can use objects to actually position myself into standing back upright."

Keith, stroke survivor

There are also some practical things you can do to avoid falls:

  • Keep floors clear of trailing wires, loose rugs, clutter or anything you might trip on
  • Use non-slip mats in the bathroom
  • Mop up spills straightaway
  • Make sure rooms are well lit
  • Wear well-fitting shoes or slippers with a good grip

Preventing a fall: Balance aids and equipment

There are adaptations you can make around your home to help you avoid falls. Age UK have a guide that covers all areas of the home. Everything from answering the door to moving around your kitchen.

If you are often alone and worried about falling, there are products that you can use. These can detect falls and get in touch with your emergency contacts. They are often referred to as telehealth products.

Outside the home, there are a few different aids you might find useful for managing your balance and preventing falls.

A walking stick or four-point cane can give you stability and confidence when moving around. It can also be a signal to others that you need more time and space.

There are dedicated supports for people with foot drop. These are usually referred to as splints, but the technical name is ankle-foot orthosis. They lift your toes and support your ankle to prevent you catching your toes when you step forward.

Speak with your GP or physiotherapist if you think you might need an aid to help your balance.

Preventing a fall: Physiotherapy for balance problems

There are many different therapies when it comes to improving your balance and preventing falls. Your GP and physiotherapist can suggest the right ones for you. These may include:

  • Physiotherapy and balance retraining. A physiotherapist can prescribe exercises to address your balance problems. These might focus on strengthening certain muscle groups or practicing navigating around objects.
  • Staying active. Staying active is an important part of a healthy lifestyle. It's also a great way to support the work you're doing with your physiotherapist. See our Getting active after stroke page for more ideas about staying active.
  • Gaze stabilisation. You may be prescribed gaze stabilisation exercises if your balance problems are the result of vision problems. These exercises will be done under the guidance of a specialist physiotherapist.

It is important to do the physiotherapy you are prescribed. You can always speak to your physiotherapist if you struggle with a particular exercise or get bored with the exercises. They can suggest alternatives. You can read more about physiotherapy after stroke in our guide.

We also have a PDF with more information about balance problems you can download directly or order a print copy from our store.

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