How neurological disorders affect balance and what you can do about it

Balance problems are a common feature of many neurological conditions. Nervous system disorders that can affect balance include:

  • Parkinson’s disease
  • Multiple sclerosis
  • Lewy body disease
  • Meniere’s disease
  • Peripheral neuropathy
  • Cortico-basilar degeneration
  • Progressive supranuclear palsy
  • Motor neurone disease
  • Huntington’s disease
  • Chiari malformation
  • Spinal cord injury
  • Brain tumour
  • Dementia
  • Stroke

How does balance work?

To understand why neurological conditions cause balance problems, it helps to know a bit more about how balance works.

The human balance system is complex. Staying steady on your feet and successfully responding to balance challenges (such as riding a bike, being jostled in a crowd or tripping over something) requires harmonious interaction between several body systems. They are:

  • vision ­– which provides your brain with visual information about where you are and your environment
  • the inner ear (vestibular system) – which detects movement of your head through special sensory cells
  • nerve receptors in joints, muscles and tendons – which provide information about the effort, force, and size of your movements
  • your spinal cord and brain – which receive, process and respond to this information.

How neurological conditions affect balance

Maintaining your balance requires your nervous system to both anticipate and respond to what is happening in your body (such as breathing and movement) and in your environment (such as obstacles in your pathway).

When all the above systems are working well, a continuous feedback loop between sensory receptors in the body and the nervous system allow you to automatically adjust your balance as needed.

Because the nervous system (the brain and spinal cord) is vital for receiving and responding to balance and postural information, conditions that affect the nervous system often result in balance problems.

Any injuries or conditions that affect any of these systems can therefore impair our balance.

MS and balance

People with MS can develop balance problems as a result of damage to the nervous system. Balance problems and dizziness are common in people with MS and can be early signs of this neurological condition.

MS exercises for balance

MS affects people very differently. Therefore, figuring out the best way to manage balance problems in people with MS requires a tailored approach that targets your individual needs.

MS exercises for balance may include static, dynamic and reactive balance training, to help you both maintain postural stability and react to environmental balance challenges. It may also include vestibular training exercises and compensation techniques.

Fatigue and spasticity – other common MS symptoms – can also impact balance and therefore may need to be addressed.

A physiotherapist or exercise physiologist, like our experienced professionals at Active Ability, can conduct a thorough assessment and develop an exercise program that’s tailored to your needs and goals.

Showing Multiple Sclerosis who is boss!

At Active Ability, we see hard working clients on a daily basis, and Danielle is one example. We asked Danielle to share her story about how she manages MS.

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is a neurological condition affecting the nerves in the body and brain. Nerve fibres transmit messages from our brain to the body and back again. These nerves are wrapped in a sheath known as myelin. In MS, the myelin sheath is attacked, causing inflammation and damage, resulting in lesions at that site. The lesions cause a variety of symptoms depending on which nerves are affected. Typically, the difficulties faced are related to impaired transmission of messages from the brain to the muscles of the body.

How did Danielle find Active Ability?

I spoke with my NDIS (National Disability Insurance Scheme) support co-ordinator who suggested I give Active Ability a call to arrange an appointment. Kara from Active Ability was extremely prompt in calling me, discussing my individual needs, and organising my exercise physiologist, Emma.

Background of Danielle’s condition

I was diagnosed with Primary Progressive Multiple Sclerosis (PPMS) in October 2016. The first year after diagnosis was extremely stressful as I didn’t know why my body was shutting down. It took a year of tests, MRIs, lumbar punctures and blood screening to finally diagnose MS. Once I had confirmation of what I had to face, I made the decision to fight this debilitating disease. Emma provided me with the tools to establish achievable goals, and we are working towards them with each session.

young blonde woman who has multiple sclerosis doing balance exercises standing on one leg
Danielle does balance training as part of her home exercise program for managing MS

How exercise has improved Danielle’s condition?

I know the last thing you feel like doing when you have MS is exercising, but it is about your mindset. If you can just convince yourself to get started, the rest is easy. I have had a fantastic experience with Active Ability. Kara has been wonderful in finding the amazing Emma to put together a program specifically designed to my needs.

Where to from here for Danielle?

Danielle is consistently training with Emma and is diligent with home exercises twice a week. She is determined to improve her walking ability and leg strength and will be making the commitment to exercise sessions three times a week.

: young blonde woman who has multiple sclerosis doing arm strength exercises using a green resistance band
Danielle’s exercise program also includes strength training to help manage her MS symptoms

Balance and Parkinson’s disease

Parkinson’s disease (PD) affects a part of the brain that is vital to balance control called the basal ganglia.  This leads to the postural instability, freezing, difficulty turning and falling that are associated with this neurological condition.

The brain changes associated with PD also affect gait, causing people to take small, shuffling steps. This can lead to trips and falls.

Parkinson’s balance exercises

For people with PD, the right type of exercise program can help improve your walking and your balance.

Balance exercise for Parkinson’s disease may include training to take bigger steps and turn around.  It may also include dynamic balance exercises such as shifting your body weight from one foot to the other, climbing stairs and changing directions.

The team at Active Ability are experts in assessing and managing the balance problems associated with Parkinson’s disease. We can create a personalised program designed to suit your current ability level and your goals, considering factors such as your medication regime and home/work environment.

woman with a neurological condition and balance problem using a four-point stick to walk along a footpath
Balance exercises can help people with stroke and Parkinson’s disease to stay mobile

Balance and stroke

Stroke is another common neurological condition that can lead to balance problems. A stroke occurs when an area of the brain is damaged due to a haemorrhage (bleed) or a loss of blood flow.

Strokes often causes weakness on one side of your body, which can make it difficult to balance. For example, a weak leg can make you feel unsteady or have difficulty with lifting your foot high enough that you don’t trip while you’re walking.

Strokes also frequently lead to reduced sensation on the affected side. When you can’t feel where your leg and foot are, it’s very hard to know how to move.

When the damage includes an area of the brain directly involved in balance control – the cerebellum and brainstem – you may experience vertigo or dizziness as well as loss of balance.

Balance exercises for stroke patients

Strokes can affect different parts of the brain and impact every person differently. If you’ve had a stroke and it has affected your balance, it’s important that you are assessed by a qualified professional, such as the exercise physiologists and physiotherapists at Active Ability.

Along with reviewing your current function, they will consider things like your environment, medications, energy levels and other health conditions.

Then they can design a program that’ s tailored to your specific needs and goals. This may include strength training for your affected side and strategies to improve your sensory awareness, along with static and dynamic balance training.


Active Ability see clients with neurological conditions in the comfort of their home or another preferred environment, such as their workplace or gym.

If you have balance problems associated with your neurological condition, find out more about how we can help you here.

Or get in touch with us on (02) 8678 7874, or via our contact form