Balance Exercises

If you are admitted to hospital, it is important to keep active where possible.

This booklet will outline important information regarding what exercises to complete while in hospital and when returning home, to aid with maintaining muscular strength and regular movement of the body.

How do I improve my experience with exercising?

If you do not usually exercise or are unable to complete long periods of exercise, any physical activity you can do is better than none at all.

For example:

•  If you feel you need help with exercises, ask your family or friends when they come to visit.

•  The most important thing to remember when doing your exercises is to start small and build up your tolerance gradually.

•  During the first few months of increasing your physical activity following your admission, it may be helpful to be active with other people.

To reduce your risk of ill health from being inactive, it is nationally advised that adults and older adults should exercise regularly for at least 2 hours and 30 minutes, a week and reduce the amount of time spent sitting or lying.

What are the benefits of exercising?

Improves your muscle strength that can reduce with ageing. 

•  Reduces your risk of coronary heart disease, stroke, various cancers and diabetes.

•  Can increase your life expectancy.

• Helps keep your independence and taking part in your usual daily tasks.

•  Improves your mental being and brain functions. This can help with managing stress and improving quality of life.

•  Can reduce levels of stress and anxiety.

• Helps improve your self-confidence.

•  Reduces the risk of accidental falls and fall-related injuries.

• Improves bone health and how well you can move, making daily tasks easier to complete.

Introduction to Balance Exercises

This leaflet will demonstrate the key exercises that we promote to improve upper limb and lower limb strength, alongside specifically improving your balance, coordination and mobility.

Each exercise will include a small explanation, alongside the sets and repetitions we advise you to try when completing your exercises. A ‘repetition’ (reps) is each time you complete one whole movement, a ‘set’ is how many times each repetition/movement is completed in a row (you may set a target to achieve before completing your exercises). For example: when completing your first exercise ‘reaching forward in sitting’ – each time you reach forwards this is one repetition. If you were to complete 10 repetitions in a row, this would be 1 set of 10 repetitions.

Each exercise should be completed to your own ability, and you should follow the advice as noted on each individual exercise with regards to making each one easier or harder.

Balance Exercises

Exercise 1: Reaching forward in sitting

Sit upright with your feet placed flat on the floor and shoulder width apart. Raise both hands in front of you and lean forward. Return to starting position.  Do 2 sets of 10 repetitions.When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Initiate or complete a sit to stand.

If this is too hard:

• Reduce the number of repetitions.

• Reduce the distance you lean forwards.

Why?

This exercise helps strengthen your back, arm and abdominal muscles. It will help with normal day to day activities like: standing up and picking items up from a table.

Exercise 2: Side reaching in sitting

Sit upright with your feet placed flat on the floor and shoulder width apart. Raise one arm out to the side at shoulder level, reach out to the side then return to the starting position. Repeat on the other side. Do 2 sets of 5 repetitions. When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10

• Bring both feet closer together.

• Stand on a different surface i.e. pillow.

If this is too hard:

• Increase the distance between your feet.

• Reduce the distance you reach out.

Why?

This exercise helps strengthen your shoulder and abdominal muscles. This will help with normal day to day activities like: washing, dressing, reaching into cupboards and reaching across from a chair.

Exercise 3: Torso twists in sitting

Sit upright with your feet placed flat on the floor and shoulder width apart. Keep your elbows tucked into your side and elbows bent, twist your upper body from one side to the other. Do 2 sets of 5 reps in each direction. When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Reach across with your arms rather than keeping them tucked in.

• Do the exercise while standing.

If this is too hard:

• Reduce the repetitions.

• Reduce the distance you reach out when twisting.

Why?

This exercise helps to strengthen your abdominal muscles. This helps with normal day to day activities like: reaching around you, sitting up, putting your seatbelt on and changing position in a chair.

Exercise 4: Marching in sitting

Sit upright with your feet placed flat on the floor and shoulder width apart. Bring your right knee up towards your chest and return to starting position. Repeat with your left knee. Do 2 sets of 5 reps each leg. When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Add resistance band .

• Hold knee up for 5 seconds.

• Do this movement while standing.

If this is too hard:

• Reduce the repetitions

Why?

This exercise helps to strengthen your hip, thigh and buttock muscles, and will improve the flexibility and movement within your hips and lower back. Marching in standing will improve balance whilst increasing core stability. This helps with normal day to day activities such as sitting up, washing, dressing, standing up and walking.

Exercise 5: Initiating a sit to stand

Begin by sitting in a chair with arms. Keep both your feet flat on the ground and shoulder width apart. Lean forward and place your hands on the arms of the chair. Bring your feet close into the chair and lift your hips off the chair. Do 2 sets of 10 reps. When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Complete a full sit to stand.

If this is too hard:

• Reduce the repetitions.

Why?

This exercise helps to strengthen your leg and abdominal muscles. This helps with normal day to day activities such as standing up, sitting down and reaching forwards to an object in front of you.

Exercise 6: Staggered sit to stand

Begin by sitting in a chair with arms. Keep one foot flat on the ground and one foot outstretched with just your heel on the floor. Lean forward and place your hands on the arms of the chair. Stand up using one leg that is planted on the ground. Do 2 sets of 5 reps with each leg. When these start to become easier over time:

• Increase the number of sets to 3 and repetitions by 5 to 10 reps.

• Hover the outstretched foot above the ground.

If this is too hard:

• Lower the repetitions

• Use both legs for sit to stand

Why?

This exercise helps to strengthen your leg muscles and improve your balance. These muscles are key for keeping your legs strong enough to mobilise. It will help with normal day to day activities such as standing up, sitting down, picking up items from the floor and walking.

Exercise 7: Tandem walk

Standing upright, place one foot in front of the other and walk in a straight line as if you were on a tight rope. Do 2 sets of 10 reps with each leg. When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Tandem walk over different surfaces i.e. pillows, cushion.

If this is too hard:

• Hold onto a supportive surface, such as wall/rail/kitchen counter.

Why?

This exercise helps to strengthen your leg and abdominal muscles. This will help with improving coordination, balance, posture and general mobility. This helps with normal day to day activities such as: walking and standing.

Exercise 8: Heel-toe walking

Standing upright on your tip toes, walk around the room, keeping your heels raised above the ground. Then standing upright on your heels, walk around the room keeping your toes raised above the ground.

Do 2 sets of 10 reps. When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Walk with a weight in your hands i.e. tin of beans, bottle of water.

• Walk on different surfaces i.e. pillow/cushion.

If this is too hard:

• Reduce the repetitions.

• Place hands on a supportive surface i.e. kitchen counter.

Why?

This exercise helps to strengthen your shoulder muscles. This makes daily activities easier due to overall improvement of your shoulder function.

Exercise 9: Three-way hip strengthening

Stand upright with your legs together next to a supportive surface. Place a hand on the surface/wall. Keeping your legs straight, raise one leg forward away from the body and then back to starting position. Then raise the same leg backwards away from the body, keeping it straight and then bring it back to the starting position. Then keeping your leg straight raise it out to the side away from the body and return to starting position. Repeat this with the other leg and alternate. Complete 2 sets of 10 reps for each leg movement. When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Add a small weight around your ankle if appropriate or use a resistance band around your thighs.

• Do the exercise without holding on to an object.

If this is too hard:

• Step forward, back and to the side rather than lifting your foot above the ground

• Place both hands on a supportive surface.

Why?

This exercise helps to strengthen your hip and buttock muscles. This will help to improve the stability of your hips and your balance when moving. This will aid with completing normal day to day activities like: walking, marching, taking steps to the side and stepping backwards.

Exercise 10: Windmill

Standing upright with your feet shoulder width apart, point both arms out to your side. Keeping your legs straight twist your torso and bend forward so that your right hand touches your left foot. Return to starting position and repeat with the other side. Do 2 sets of 5 reps.

When these start to become easier over time:

• Increase the number of sets to 3 and the repetitions by 5 to 10.

• Narrow the distance between your feet.

• Stand on a different surface i.e. pillow, cushion.

If this is too hard:

• Increase the distance between your feet.

• Reduce the distance you lean forward when bending forward.

Why?

This exercise helps to strengthen your leg, abdominal and shoulder muscles. This will help to improve your balance and will help with normal day to day activities like: reaching down, balance when walking and standing, and reaching out for objects.

PIL1515 – Balance Exercises Progress Tracker (253kB pdf)

What do I do if I have a fall?

Although increasing physical activity levels can reduce the risk of accidental falls and falls-related injuries, falls can still happen. If you have had a fall, lost your confidence or became unsteady on your feet, it is even more important that you stay active and complete your exercises daily (NHS Inform, 2023).

If you do have a fall, the following information can help with remaining safe:

• Do not panic!

• Use a telephone, pendant alarm, or try to shout for help.

• Do not move if you feel any sort of pain or know that you have injured yourself.

• If you are not injured following the fall, you may want to attempt to get onto your hands and knees near the closest chair first before getting up.

• If you have attempted to get up but are unable to, you need to keep warm! Try to keep your arms and legs moving regularly and cover yourself with anything close by.

• After a fall, you should always tell your doctor and health care professionals; even if you were successful on getting yourself up following the fall and do not feel injured.  

References List

• NHS Inform (2023) Keeping active to help prevent falls. Available at: https://www.nhsinform.scot/healthy-living/preventing-falls/keeping-well/keeping-active-to-help-prevent-falls (Accessed on: 18 May 2023)

• Alberta (2019) How to get up from the floor by yourself. Available at: https://myhealth.alberta.ca/Alberta/Pages/get-up-by-yourself-fall-prevention.aspx  (Accessed on: 19 May 2023)

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]