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9 Ataxia Physiotherapy Exercises to Try at Home

Mar 08th, 2024 | by Kaitlyn Fuller, PT, DPT

Kaitlyn Fuller, PT, DPT

March 08th, 2024

What Is Ataxia?

You’ve probably heard your therapist or your paediatrician talk about ataxia. But what is ataxia? Ataxia is a neurological disorder that affects balance, coordination, and speech. People with ataxia may have difficulty with everyday activities, such as walking, running, and writing. In this blog, NAPA PT Kaitlyn is here to share ataxia exercises used in physiotherapy to help improve balance and motor coordination, making everyday activities easier.

What Causes Childhood Ataxia?

Childhood ataxias may be acquired or inherited. Ataxia is most frequently caused by damage to or dysfunction of the cerebellum and its associated connections.

Childhood ataxias may be acquired or inherited.


Key Challenges for Children With Ataxia

The primary impairments of cerebellar ataxia we see as paediatric physiotherapists include:


Ataxia Exercises to Try With Your Child at Home

Click here for a correlating video on our Facebook page of all the exercises below!

1. Sit to Stand – Focusing on Motor Control and Overall Strength

  • Instructions: Start off sitting in a supportive chair (the higher the surface, the easier the transition) focusing on weight shifting forward (nose over toes) to stand up, and attempt to perform without the use of arms
  • Increase the challenge: Lower the surface to the floor (i.e., a step stool or stair); or a dynamic surface (i.e., placing a wobble disc on a surface or transitioning sit to stand from a small therapy ball)
  • Decrease the challenge: Sit behind the child and provide support at the hips


2. Bird Dog – Focusing on Core Stability With Motor Planning and Balance on Hands and Knees

  • Instructions: Start in hands and knees position and reach with arm and opposite leg and hold for 3 seconds
  • Increase the challenge: Have the child kneel on a dynamic surface (i.e, a pillow, couch cushion, or wobble disc)
  • Decrease the challenge: Have the child just hold up 1 arm or 1 leg at a time, you can also provide support at the child’s hips


3. Modified Single Limb Stance – Focusing on Balance

  • Instructions: Standing in an open area without assistance to the upper extremity, bring 1 foot up onto a stable surface and hold for 5-10 seconds (if this is difficult, you can make it easier by decreasing the height of the step)
  • Increase the challenge: Have the child lift a leg onto a dynamic surface (i.e., pillow, couch cushion, wobble disc) or have the child perform a true single-leg stance (i.e., standing on 1 foot)
  • Decrease the challenge: Support the child at the hips


4. Targetted Stepping – Focusing On Motor Planning, Motor Control, and Balance

  • Instructions: Child starts by standing on a stable surface and stepping to a targeted spot on the floor (you can use painter’s tape, stickers, or large rings for a visual cue)
  • Increase the challenge: Have the child stand on a dynamic surface (i.e., pillow couch cushion, or wobble disc)
  • Decrease the challenge: Provide support at the child’s hips and/or have them step to 1 specific spot and then hold in that position for 3-5 seconds


5. Standing Balance – Focusing on Balance and Safety

  • Instructions: Have the child start by standing independently in an open area and give them taps/nudges to their trunk (front, back, side) have them attempt to maintain balance while you are trying to throw them off balance
  • Increase the challenge: Have the child stand on a dynamic surface (i.e. a pillow, couch cushion, or wobble disc)
  • Decrease the challenge: Have the child seated or in tall kneeling position to perform the activity


6. Stepping Over Obstacles on the Floor – Focusing on Motor Planning and Motor Control

  • Instructions: Place objects on the floor for the child to step over, this could be an agility floor ladder or painter’s tape on the floor
  • Increase the challenge: Elevate the object that they are stepping over. This could be done using blocks, tissue boxes, paper towel rolls
  • Decrease the challenge: Provide support at the hips when stepping over obstacles


7. Red Light, Green Light – Focusing on Motor Control and Motor Planning

  • Instructions: If the child is able to ambulate independently, play Red Light, Green Light, making sure they stop within 3 steps once they hear “Red Light”
  • Increase the challenge: Have the child perform with backward steps or side steps
  • Decrease the challenge: The child can perform in a gait training device, walker, or wheelchair


8. Weighted Hamper Push – Focusing on Heavy Work

  • Instructions: Place heavier objects in a laundry hamper to mimic a sled push. Have the child push the hamper around the home. Bonus tip: Make this a game to find objects and put them in the hamper!
  • Increase the challenge: You can increase the weight in the hamper or have them move through a specific path
  • Decrease the challenge: Provide support at the hips or hand-over-hand assist


9. Wheelbarrow Walks – Focusing On Heavy Work and Overall Strengthening

  • Instructions: The child starts on the floor on their belly and the parent/caregiver will assist the child by holding them at the ankles. Have the child walk 3×10 ft. with breaks if needed
  • Increase the challenge: Have the child perform for longer distances and/or have them wheelbarrow walk around obstacles
  • Decrease the challenge: Assist more proximally to thighs or pelvis/hips


10. Balance Beam – Focusing On Motor Planning, Balance, and Motor Control

  • Instructions: Use a balance beam or painter’s tape on the floor (you can use multiple strips of painter’s tape to make the beam wider), and have the child walk across the beam with heel-toe
  • Increase the challenge: Make the beam more narrow or have the child walk backward
  • Decrease the challenge: Provide support at the hips or have the child place 1 hand on the wall


Bonus Tip: Try a Weighted Vest With These Ataxia Exercises

Research has shown that a weighted vest has had positive benefits for children with cerebellar ataxia. If you have a weighted vest at home, you can try this with the exercises. If you don’t have a weighted vest, you can try to place ankle or wrist weights on the child’s shoulders or around their waist.

Find Additional Resources and Inspiration in the NAPA Blog:


About the Author:

Kaitlyn is a physiotherapist at NAPA Center Austin, originally from central New York who received her DPT from the University of Vermont. Outside of her love for the kiddos she enjoys spending time with family, friends, and her puppy Nash, listening to live music, and rooting for the New York Rangers.

About NAPA Centre

NAPA Centre is a world-renowned paediatric therapy clinic, offering weekly and intensive therapy for ataxia at our multiple clinic locations throughout Australia, U.S., and U.K. NAPA is committed to helping children lead their happiest, healthiest lives by providing the best and most innovative paediatric therapy methods from around the world all under one roof. Let your child’s journey begin today by contacting us to learn more.

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