Core and Balance Exercises for Spinal Cord Injury

These exercises are designed to develop sitting balance and strengthen the core after a spinal cord injury. 

The patient in the photographs was close to discharge, so balance was good. This posture would not be realistic for patients first admitted.

Exercise 1

In this exercise sit on a bed while someone stands behind you. 

  • Take one hand off the bed at a time to get used to not relying on your arms for support to sit.
  • Take both hands off the bed. Start with your hands not too far off the bed so you can put them down quickly to stabilise yourself if needed.
2 photos of patient - 1. Lifting one arm off bed in front, and 2. Lifting both arms off bed and stretching them out in front

Exercise 2

In this exercise sit on the bed while someone stands behind you. 

  • Twist to the left side, then come back to the centre and then twist to the right.

  • Start off with small movements. Once you can start to make larger twists, the person helping you should introduce their hand as a target for you to touch at each side.

Exercise 3

Sit on the bed while someone stands behind you for support.

  • Lift your arms out, lean to one side taking the weight out of the centre and then return to the centre for a rest.
  • Do the same on the other side. 
  • Start with very small movements to each side. The person who is helping you can have their hands by your side to give you a target to aim for.
Leaning from side to side

Exercise 4

This activity is good for the core.

Sit on the bed while someone stands behind you for support.

  • Take a a heavy object. Move it to each side and then lift it above your head.
  • First lift the object to your nose, then to your forehead then above your head.
Holding a heavy object at side and then above head.

Exercise 5

Take a beanbag and throw it into a bowl.

Sit on the bed while someone stands behind you for support.

Have a pile of beanbags behind you so you have to reach back to grab a beanbag. The idea is to throw the beanbags into a container on the floor. 

This activity can be made simpler or more challenging.

To simplify exercise 5:

  • Use an over-arm throw
  • Have the target container closer to you
  • Moving beanbags closer within reach
  • Have one hand on the edge of the bed

To make exercise 5 more challenging

  • Use an under-arm throw
  • Have the target container further away
  • Move beanbags further away from you

Exercise 6

Sit on the bed while someone stands behind you for support.

Have the person helping you  place an object beside you. With both hands off the bed, aim to touch your elbow onto the object and bring yourself back up without losing balance or relying too much on the object.

Someone sitting on a plinth leaning to one side then another to put elbow on top of foam dice.

To simplify exercise 6:

  • Use a firm object so you can use this to lean on to sit back up

To make exercise 6 more challenging

  • Use a soft or squishy object so you can’t put too much weight on it and have to use your core

Exercise 7

This exercise should be completed when you have developed enough sitting balance so that you don’t need someone sitting behind you. 

Hold a Velcro paddle. Have someone stand in front of you and throw a ball for you to catch with the paddle.

To simplify exercise 7:

  • Have the person helping you stand close to you and deliver short throws. 
  • Ask them not to throw outside of your reach

To make exercise 7 more challenging

  • Have the person helping you stand further away when throwing.

  • Ask them to throw at different heights

  • Ask them to throw to the side to make you take your weight out of the centre.

Exercise 8

Someone placing rings onto a pole.

Sit on the bed while someone stands behind you or to the side for support if necessary.

The idea of the exercise is to put rings on a pole. 

To simplify exercise 8:

  • Place the rings or counters close to you
  • Place the table/game close to you
  • Use one hand to stabilise yourself

To make exercise 8 more challenging

  • Place the rings or counters behind you or to the side of patient
  • Move the game further away to challenge the core/reaching forward movement

Exercise 9

3 pictures - one with OT holding hands with person with spinal cord injury bringing them to a leaning forward position, and then pushing themselves into an upright position with hands on OT shoulders

Sit on the bed with someone sitting facing you.  Your helper should hold your hands and slowly bring you forward. The aim is for you to bring yourself back up into a straight position.

To get into position your helper can hold one of your hands. Aim to touch your helper’s shoulder as a guide of how much to come forward. 

Your helper can put their hands on your trunk for support and to reassure you that you won’t fall forward. Come forwards and touch your helper’s shoulders and from there try to sit back up straight. 

To make exercise 9 more challenging

  • have your helper sit further back so their shoulders are harder to reach, making you come further forward. 

Exercise 10

Anything that involves bringing a heavy ball higher than head level will test your balance and core. 

A good example of this which can be done in a wheelchair or on a bed is shooting baskets.  (It will help to take the arms out of your wheelchair). 


Someone in a wheelchair shooting baskets
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