Asanaverse

Balance and Movement After Stroke

8 Week Adaptive Yoga Program for Balance After Stroke

Rehab ended and something was still missing. Standing up from a low chair takes a plan. Turning around in the kitchen takes a hand on the counter. You are steadier than you were and you are not steady, and there is nothing scheduled any more that is working on it.

Our yoga teachers built this eight week program on the dosage that the two most successful trials in this area used: twice a week, for eight weeks, starting entirely seated. Three weeks sitting, three weeks on the floor building strength, then two weeks standing with a chair in front of you.

Twice a week, plus ten minutes on a third day. Four sequences, eight weeks. Frequency matters more than length here: the two trials that ran twice a week found balance improvements and the one that ran once a week did not.

Length

8 weeks

Practices

24 in total

Rhythm

Twice a week, plus ten minutes on a third day

Made for

Adults at least six months after a stroke, medically stable, rehabilitation finished

What the research says

The honest starting point is the Cochrane review, because it is not a flattering one. It found exactly two randomised trials with 72 people, pooled their balance scores, and found no significant effect: a mean difference of 2.38 points on the Berg Balance Scale, with the evidence graded very low. Its conclusion is that there is not enough information to confirm or refute yoga as a stroke rehabilitation treatment.

The single trials are more interesting than the pooled result. In the larger of the two, 47 people with chronic stroke did twice weekly sessions for eight weeks with a registered yoga therapist. Between the groups there was no significant difference. Within the yoga group there was: balance improved from 41.3 to 46.3 on the Berg Balance Scale, and the proportion of people afraid of falling dropped. That is a within-group result and we are calling it one.

The other trial ran ten weeks at once a week and found no improvement in objective motor or balance measures at all. What it did find was better perceived motor function, better memory-related quality of life, and clinically meaningful drops in anxiety. Comparing the two, the difference that stands out is frequency rather than duration, and that is why this program runs twice a week.

See every study and guideline behind this program →

How the program works

3 phases, and you stay with the same practices for the whole of each one. That repetition is the plan rather than a shortage of ideas. A body changes when the same ask comes back often enough, and the trials this program follows repeated for weeks before they made anything harder.

Weeks 1 to 3MoveBuild accurate movement where balance cannot be lost.Weeks 4 to 6BuildBuild the back, hip and leg strength that standing later depends on.Weeks 7 to 8IntegratePut it into the movements that fill an ordinary day.

Twice a week, thirty to thirty-five minutes, plus a ten minute seated session on a third day. Open a session below to see every pose and its timing. Two things run through all eight weeks: both sides always work together, and the less able side goes first and sets the range.

Who this is for

  • ·You are at least six months past your stroke and medically stable.
  • ·You have finished formal rehabilitation, or you are continuing it and want something alongside.
  • ·You can sit unsupported and manage a transfer, with help if needed.
  • ·You can follow instructions from a screen without someone correcting you.
  • ·You have a wall and a solid chair, and someone nearby when you practise standing.

Before you start

This is for the chronic, stable phase, at least six months out, and it is an addition to rehabilitation rather than a replacement for it. Every trial behind it ran in person, in a small group, with a yoga therapist who could physically steady someone. A page cannot do that, which is why the first three weeks never leave the chair and why every standing position here names the wall or chair you are holding.

Read the full safety notes in the practice guide →

The practice

Two practices per phase. Open one to see every pose, its timing and the reason it sits where it does.

Move · Weeks 1 to 3

Three Weeks Seated

Build accurate movement where balance cannot be lost.

Everything in the first three weeks happens sitting, in a chair or on the floor. That is where the protocol in the strongest trial began too, with five seated breath-with-movement exercises before anything else. Weight shifting from one hip to the other, turning the trunk, moving the shoulder blades: all of it is balance work, done in a position you cannot fall out of.

  1. 1.Easy Pose3 min
  2. 2.Staff Pose3 min
  3. 3.Cat Pose2 min
  4. 4.Cow Pose2 min
  5. 5.Butterfly Pose3 min
  6. 6.Revolved Easy Pose2 min each side
  7. 7.Bharadvaja's Twist2 min each side
  8. 8.Knees to Chest Pose2 min
  9. 9.Corpse Pose5 min
Open the full sequence →

Week by week

Week 1Find out which side takes more weightSitting evenly is harder than it sounds and most people are surprised by the answer. It is the first thing worth knowing.
Week 2Less able side leadsDo every turn on the affected side first, then match the other side to that range. It stops the practice quietly becoming one sided.
Week 3Practise getting down and upIf the floor is available to you, use the ending on the floor rather than the chair, and take your time getting back up. That transfer is worth as much as the poses.
← Back to the balance and movement after stroke practice guide

Build · Weeks 4 to 6

Strength, Mostly Lying Down

Build the back, hip and leg strength that standing later depends on.

The middle three weeks add ten minutes of standing at a wall and then go to the floor for the rest. Back extension on your front and a hip lift on your back are the two positions in the documented protocol that build what standing up from a chair actually needs, and both are done with the floor already underneath you.

Week by week

Week 4The hand stays on the wallFor the whole standing section, every week. There is no version of this phase where letting go is the progression.
Week 5Check which foot pushesIn the hip lift, notice whether one foot is doing most of the work. Evening that out is the actual exercise.
Week 6Roll to the side to get upEvery time, from now on. It is the safest way off a floor and it becomes automatic faster than you would expect.
← Back to the balance and movement after stroke practice guide

Integrate · Weeks 7 to 8

Standing, and the Sit to Stand

Put it into the movements that fill an ordinary day.

The last two weeks are twenty minutes standing with a chair in front of you, and they include the movement that matters more than anything else in this program: sitting down and standing up, five times, slowly. Balance confidence improved alongside balance in the trial data and fear of falling dropped, and both of those change what someone is willing to do in a week.

Week by week

Week 7Slow is the whole pointIn the sit to stand, going slowly is harder and it is what builds control. Five slow ones beat fifteen quick ones.
Week 8Keep this oneThere is nothing after week eight that replaces it. Twice a week for as long as it is useful is the plan, and the seated sequence covers the weeks when it is not.
← Back to the balance and movement after stroke practice guide

The 19 poses in this program

Every pose has its own page with alignment, common mistakes and the energetic effect. Look one up when a shape does not make sense in your body.

Easy PoseStaff PoseCat PoseCow PoseButterfly PoseRevolved Easy PoseBharadvaja's TwistKnees to Chest PoseCorpse PoseMountain PoseMountain Pose with Side BendUpward SaluteBaby CobraLocust PoseBridge PoseWarrior IITriangle PoseTree PoseChair Pose
Go to the Asana Lab →

The guide behind this program

Why these poses and not others

The Balance and Movement After Stroke practice guide explains what each pose does and why it belongs to this goal. It also carries the safety notes and every study this program is built on. Read it if you want the reasoning rather than the plan.

Read the guide →

Frequently Asked Questions

How soon after a stroke can I start this?

At least six months, medically stable, and after formal rehabilitation has finished or alongside it. The trials this is based on studied people who were on average four to nine years past their stroke. The acute and subacute phase belongs with a physiotherapist who can put hands on you.

Does yoga improve balance after a stroke?

The single trials are more encouraging than the pooled evidence. In the largest, balance improved within the yoga group from 41.3 to 46.3 on the Berg Balance Scale over eight weeks, with no significant difference against the waiting list group. The Cochrane review that pooled two trials found no significant effect and graded the evidence very low. Both of those are true at once.

Why twice a week?

Because that is the difference that stands out between the trials. The two that ran twice weekly for eight weeks found balance improvements. The one that ran once weekly for ten weeks found none on objective measures. Three studies is not proof of a mechanism, but the pattern is consistent and it is what this program follows.

Can I do this if I cannot get to the floor?

Yes, for the whole of the first phase. Every position in the first three weeks has a chair version, including the ending. The floor work in weeks four to six does need the floor, and if getting down and back up is not reliable yet, staying with the seated sequence for longer is a reasonable plan.

Is this a replacement for physiotherapy?

No, and nothing in the research supports treating it as one. Every control group in these trials was a waiting list rather than active physiotherapy, so there is no evidence comparing the two. The one trial that added yoga on top of standard rehabilitation is the closest model for how to use this.

What about the standing poses if I am unsteady?

Every standing position in this program names a wall or a chair to hold, and the holding hand does not leave. If standing is uncertain, have someone in the room for those sections. That is a straightforward instruction rather than a warning: the trials had a yoga therapist present who could steady people, and this is how a page substitutes for that.

Creator of this program

Manish Rana

Manish Rana

Founder of Asanaverse.de. Manish writes about yoga, Ayurveda and meditation, and owes his deep connection to yoga to his Indian roots. With over 1,000 hours of Yoga Alliance Teacher Training, he shares his knowledge with the community.

More about Manish →
Registered Experienced Yoga Teacher, E-RYT 500

Where to next

All programs

See the other programs

Every program here was built around one complaint and around the trials that studied it. Back, neck, knees, hips, sleep and stress, each one running for as long as the research says it takes.

Browse programs →