6 Ataxia Exercises To Support Balance and Coordination

Medically reviewed by Federica Polidoro, M.D.

Written by Marianne Moser, PT, DPT, FAAOMPT, CSCS

Posted on August 31, 2026

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Key Takeaways

People with ataxia often experience poor balance and coordination, which can make moving around safely more challenging.
Physical therapy exercises like sit-to-stands, weight shifting, target reaching, and ball tossing can help improve balance and coordination for people with ataxia. These exercises can also help increase independence, maintain mobility, and reduce the risk of falls.
Before starting any new exercise routine, it is important to check in with your medical care team, and working with a physical therapist can help you find exercises that are tailored to your specific symptoms and needs.

View all takeaways

In people with ataxia, poor balance and coordination can make it harder to move around safely. Physical therapy exercises that target balance and coordination can help maintain mobility, improve safety, increase independence, and reduce fall risk.

In this article, we’ll go over some balance training and coordination exercises for people with movement disorders. You can also work with a physical therapist to get exercises tailored to your specific symptoms and needs. Before starting a new routine, it’s best to check with your medical care team to ensure your safety.

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1. Sit-to-Stands

Sit-to-stands are a great functional mobility exercise. They help coordinate changes in position and shifting weight onto your feet. They also help increase lower body strength, which is important in balance.

How To Do It

Start sitting in a chair (the higher the chair, the easier the exercise will be).

Slowly shift your weight forward onto your feet as you rise from the chair. Try to do it without using your hands, but if it’s too difficult, you can use your hands for support on the chair.

Then slowly lower yourself back into the chair. Try repeating this five to 10 times in a row.

For Children

For smaller children with Friedreich ataxia or a similar disorder, it might be helpful to have a toy raised in the air to motivate them to stand up.

You can also make a game about challenging them to sit down as slowly as possible to work more on their strength.

2. Weight Shifting Exercises

Weight shifting exercises can help your body relearn where your weight is centered in your feet. Proprioception, the sense of knowing where your body is in space, can be challenging with ataxia. Weight shifting is necessary not only for standing balance but also for the weight shift that happens when you walk.

How To Do It

For lateral weight shifts, stand with your feet about shoulder-width apart.

Slowly shift your weight to one side so it’s almost entirely on one foot, then repeat the same on the other side.

Repeat this eight to 10 times per side. If that’s easy, you can shift all the way to one side so you’re in a single-leg stance position before shifting back to the other side.

For forward and backward weight shifts, stand with your feet about shoulder-width apart.

Slowly shift your weight onto the balls of your feet, toward your toes. Then slowly shift the weight back into your heels.

Repeat this eight to 10 times per direction.

Safety Tips

If standing with your feet shoulder-width apart is too hard, you can place your feet wider apart. It’s always a good idea to do these near a handhold or surface that you can use to catch yourself if needed.

You can also reduce the amount of weight you shift in any direction to make it easier.

3. Target Reaching Exercises

Reaching exercises are great ways to work on coordinative training. Reaching combines motor control of arm movement, vision to see where a target is, and coordination of getting your hand to touch the desired target.

How To Do It

Mark a target on a wall in front of you — either with an actual target or something else, like a picture of an animal.

You can start either sitting or standing. (Standing is more challenging.) Before you reach, mentally pick the spot that you are going to reach toward.

If someone else is around, they can pick a spot for you. Practice for 60 seconds, and then take a break.

You can also set up a few objects on a table or countertop to do the same type of drill.

For Children

To make this type of exercise more engaging for children, a picture of an animal may work better. You can direct them to tap different parts of the animal. Or you can put a few of their favorite toys on a surface and direct them to reach for or tap specific ones.

4. Target Stepping Exercises

Similar to the reaching exercises, these target stepping drills help improve coordination. Instead of coordinating the upper body, these work on the lower body and also add balance.

How To Do It

Before beginning, set up three to five objects on the floor in front of you. These can be mini cones, colored tape, stickers, sticky notes, or something else that works.

Then you’ll work on tapping your foot on the targets. You can do one side at a time or alternate between sides.

Similar to the reaching drill, you can choose which target you want to go for, or you can have someone choose for you. The closer the objects are to you, the easier it’s going to be. If it becomes too easy, you can move the objects farther away from you or spread them out in different directions.

Safety Tips

Similar to other standing exercises, it’s helpful to have a handhold or surface nearby in case you need help balancing.

If you have a really hard time with balance, you can also set up a walker in front of you so it’s immediately available if your balance feels shaky.

5. Throwing and Catching a Ball

Using a ball to throw and catch can help to work on coordination and timing with upper body movements. A tennis ball or squishy stress ball works great for this exercise.

How To Do It

You can sit or stand. (Standing is harder.) Start tossing the ball up in the air and catching it in the same hand.

Do this 10 to 15 times on each side. If that becomes easy, you can start to toss it from one hand to the other, throw the ball higher, or toss it back and forth with someone.

6. Quadruped Exercises

Quadruped position means being on all fours, on your hands and knees. This is a great position to work on balance, weight shifting, and coordination of movements. This position can also help you with core stability, which will further help with balance and postural control.

How To Do It

Start on your hands and knees. You can kneel on a yoga mat or something soft to make it more comfortable.

Quadruped weight shifting is similar to the standing drills. You can practice shifting your weight from side to side and forward and backward.

For quadruped arm and leg lifts, practice lifting one arm or one leg at a time from the all-fours position. As that becomes easier, you can do opposite arm and leg extensions. This is also known as the bird dog exercise. Start with three to five lifts on each side.

Safety at Home

When working on exercises, specifically balance exercises, safety is a top priority. Make sure you have something sturdy to support you nearby. You may even want someone nearby to supervise while you’re doing these exercises.

If any exercise makes you feel unsafe, stop.

These exercises may be a bit too easy or hard for you depending on your level of function. Always check with your medical team, specifically a physical therapist, before starting a home exercise program.