Commentary: NIHR Signal: Exercise therapy may still improve balance when started a long time after stroke

Research output: Contribution to journalComment/debate


The conventional assumption is that the greatest potential for recovery after stroke is during the first few months after onset. This high quality review challenges that assumption, showing that taskspecific exercise therapy may improve balance capacity late after stroke onset. Good balance is critical for walking and undertaking activities independently and safely. Improving balance may therefore reduce falls and prevent unnecessary hospital admissions, and their detrimental consequences for quality of life and confidence of people with stroke. However therapy services are typically not set up to routinely deliver such therapy six months and more after stroke. Innovative approaches to delivering this training must be developed, alongside costeffectiveness studies showing the value of investment in such services. The task-specific nature of effective balance training means it should be orientated towards tasks that people undertake in everyday life. Working with stroke survivors and their families to find ways to empower them to safely build balance-specific training into their daily routines and activities would provide a person-centred approach likely to promote adherence. Technological solutions, such as gaming, mobile technology applications and telerehabilitation systems that people can use at home, may also be effective for supporting and monitoring engagement in therapy and for provision of remote feedback. These solutions should be developed more fully and evaluated. Time to train therapists to deliver tailored task-training through technology?
Original languageEnglish
Pages (from-to)21-21
Number of pages1
JournalFrontline: Physiotherapy Magazine for CSP Members
Issue number9
Publication statusPublished - 16 May 2018


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