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Exercise Improves Balance and Mobility in Chronic Stroke RecoveryStructured exercise improves balance and mobility for chronic stroke survivors

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Key Takeaway
Structured exercise improves balance and mobility in chronic stroke, with moderate to high certainty for key outcomes.

A meta-analysis of 2,314 adults with chronic stroke (at least 6 months post-stroke) examined the effects of structured exercise-based interventions on balance and functional mobility. The analysis focused on three validated measures: Berg Balance Scale (BBS), Timed Up and Go (TUG), and Functional Reach Test (FRT).

Exercise interventions were associated with significant improvements across all outcomes. BBS scores improved with a mean difference (MD) of 2.54 points (95% CI 1.83–3.26). TUG completion time decreased by 2.68 seconds (95% CI -3.72 to -1.65). FRT performance improved with a standardized mean difference (SMD) of 0.65 (95% CI 0.25–1.05). Certainty of evidence was moderate for BBS and FRT, and high for TUG.

Heterogeneity differed across outcomes, and the optimal training components, dose, delivery, and durability of effects remain unclear. Larger pragmatic trials with standardized reporting and longer follow-up are needed.

These findings support the use of exercise-based interventions to improve balance and mobility in chronic stroke rehabilitation. Clinicians should consider structured exercise programs as part of comprehensive post-stroke care, while acknowledging the limitations in the current evidence base.

How this fits prior evidence

This meta-analysis extends prior evidence regarding physical interventions for stroke recovery. It complements findings that square-stepping exercise may improve balance and gait, and that robotic-assisted therapy improves gait and upper-limb function compared to conventional therapy. While previous evidence for Gua Sha as an add-on for motor function was of very low certainty, this meta-analysis provides evidence of moderate to high certainty regarding the benefits of structured exercise-based interventions for balance and functional mobility.

Living with a stroke often means facing daily challenges with balance and movement. For those who are months past their initial stroke, finding ways to regain independence and stability is a major priority. New data suggests that structured, exercise-based programs can help these individuals move more confidently.

Researchers looked at data from over 2,300 adults with chronic stroke. They found that those who participated in structured exercise programs showed better scores on balance tests and performed better on functional reach tests. Specifically, participants were able to complete the Timed Up and Go test faster, which means they could move from sitting or standing to walking more quickly.

While the results are promising, there are still pieces of the puzzle missing. Because the study looked at many different types of programs, we do not yet know the exact best way to train, the ideal amount of exercise, or how long these improvements last over time. These findings show that exercise is a helpful tool for mobility, but your doctor can help determine the best specific routine for your needs.

What this means for you:
Structured exercise programs help people with chronic stroke improve their balance and speed of movement.

Common questions

How does exercise help after a stroke?

Structured exercise programs help people with chronic stroke improve their balance and functional mobility. This means patients can perform tasks like reaching for objects and moving from one position to another more effectively. The study showed improvements in three specific tests measuring balance and movement.

How much faster can patients move with exercise?

The study found that participants in structured exercise programs reduced their completion time on the Timed Up and Go test by an average of 2.68 seconds. This test measures how quickly a person can stand up, walk, and sit down, which is a key part of daily mobility.

What are the limitations of these findings?

While the results are positive, the study did not clarify the best training components or the exact dose of exercise needed. Because the programs varied, more research is needed to see how long these improvements last and to standardize the best way to deliver these exercises.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
ObjectiveTo systematically evaluate, using the GRADE framework, the effects of exercise-based interventions on Berg Balance Scale, Timed Up and Go, and Functional Reach Test outcomes in adults with chronic stroke.MethodsWe systematically searched PubMed, Embase, Web of Science, Scopus, and the Physiotherapy Evidence Database from inception to 29 June 2025 for randomized controlled trials investigating structured exercise-based interventions in adults with chronic stroke. Eligible studies enrolled adults at least 6 months after stroke onset and reported at least one validated balance or functional mobility outcome. Methodological quality was assessed using the Physiotherapy Evidence Database scale, and the certainty of evidence was rated using the GRADE approach. Meta-analyses were performed using random-effects models and expressed as mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs); exploratory univariable random-effects meta-regression was used to examine intervention duration and training frequency.ResultsSixty-nine randomized controlled trials involving 2,314 adults with chronic stroke were included. Exercise-based interventions improved Berg Balance Scale scores [MD = 2.54, 95% CI (1.83–3.26)], reduced Timed Up and Go test completion time [MD = −2.68 s, 95% CI (−3.72 to −1.65)], and improved Functional Reach Test performance [SMD = 0.65, 95% CI (0.25–1.05)]. The certainty of evidence was moderate for BBS, high for TUG, and moderate for FRT, with the degree of heterogeneity differing across outcomes.ConclusionExercise-based interventions were associated with improvements in BBS scores, TUG performance, and FRT outcomes in adults with chronic stroke, although the certainty and consistency of evidence varied across these measures. These findings support the potential role of exercise-based interventions in improving these selected outcomes. Larger pragmatic trials with standardized intervention reporting and longer follow-up are needed to clarify optimal training components, dose, delivery, and durability of effects.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42020156992, identifier CRD42020156992
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