Combined intermittent and continuous theta-burst stimulation of the primary motor cortices for upper-extremity motor recovery and cortical excitability in ischemic stroke:a randomized controlled trial

 Your incompetent? hospital can't even figure out how to deliver music therapy; they will never do anything this complicated! Unless YOU reconstitute the hospital and hire competent staff!

Combined intermittent and continuous theta-burst stimulation of the primary motor cortices for upper-extremity motor recovery and cortical excitability in ischemic stroke:a randomized controlled trial

• Changxiao Yu,
• Jiayu Zhang,
• Jianglong Zhan,
• Lifeng Zhu,
• Baiyan Liu &
• Jurui Wei 

We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.

Abstract

Background

Ischemic stroke remains a leading global cause of persistent motor disability, with upper-extremity paresis severely impairing functional independence in most survivors. Intermittent theta-burst stimulation (iTBS) and continuous theta-burst stimulation (cTBS) exert bidirectional neuromodulatory effects on cortical excitability, yet the therapeutic efficacy and neurophysiological mechanisms of combined bilateral TBS targeting primary motor cortices (M1) remain poorly elucidated for subacute stroke rehabilitation.

Objective

This randomized, double-blind, sham-controlled pilot trial evaluated the safety, clinical efficacy, and neurophysiological correlates of ipsilesional iTBS combined with contralesional cTBS (i-cTBS) for upper-extremity motor recovery in subacute ischemic stroke, with a hierarchical statistical framework to distinguish confirmatory secondary endpoints from exploratory neurophysiological outcomes.

Methods

Sixty-four patients with first-ever unilateral ischemic stroke (within 3 weeks post-onset) and upper-extremity motor impairment were randomized 1:1 to real i-cTBS (n = 32) or sham stimulation (n = 32). All participants received 10 daily sessions (5 sessions per week over 2 consecutive weeks) immediately followed by standardized task-oriented upper-extremity physiotherapy. The primary outcome was total Fugl-Meyer Assessment of Upper Extremity (FMA-UE) score. Tremor, dysmetria, and movement speed subscores served as confirmatory secondary endpoints with Bonferroni correction; motor-evoked potential (MEP) amplitude and resting motor threshold were exploratory neurophysiological measures. Group × time interactions were analyzed using a mixed-design analysis of variance.

Results

After the 2-week intervention, a significant group × time interaction was detected for total FMA-UE scores, with greater improvements in the real i-cTBS group (p < 0.001, = 0.365). Tremor and dysmetria subscores showed pronounced benefits, while movement speed showed no between-group difference. MEP amplitude of the ipsilesional M1 was selectively potentiated only in the real group (p < 0.001), and its gains were moderately correlated with motor functional improvement. No serious adverse events related to the intervention were documented.

Conclusion

i-cTBS is a safe, well-tolerated intervention that delivers meaningful(Is not 100% recovery, so still a failure per the survivor!) upper-extremity motor recovery in subacute ischemic stroke, with particular amelioration of tremor and dysmetria. The therapeutic effects are likely mediated by bidirectional normalization of interhemispheric excitability gradients and enhanced ipsilesional corticospinal plasticity, supporting its translational potential as an adjuvant therapy for early post-stroke neurorehabilitation.

Aging Brains Maintain Robust Language Networks Despite Cognitive Decline

 How will your competent? doctor exploit this to prevent cognitive decline posts stroke? Oh NO, your doctor KNOWS NOTHING ABOUT PREVENTING COGNITIVE DECLINE!  Your incompetent board of directors doesn't know how to hire competent persons! You'll have to reconstitute the hospital so your children and grandchildren get a good recovery from their strokes!

Aging Brains Maintain Robust Language Networks Despite Cognitive Decline

Summary: While executive functions like memory and problem-solving naturally decline as we age, new brain imaging research reveals that the neural network responsible for language remains preserved and fully functional. The study suggests that highly specialized brain regions are more resilient to aging compared to general cognitive networks.

Key Facts:

• Brain activity in the language processing network is nearly identical between younger (ages 17–39) and older (ages 41–80) adults.
• The “multiple demand network,” which governs executive control tasks like working memory, showed significantly reduced synchronization and weaker activation in older adults.
• Language skills typically remain stable and can even improve with age, as older adults continually build their vocabularies—functioning much like a large language model trained on a lifetime of data.

Source: Massachusetts Institute of Technology

As human beings age, many cognitive functions naturally decline. Brain scans have consistently shown age-related deterioration in neural networks responsible for executive functions, working memory, and problem-solving. But when it comes to language, the aging brain tells a completely different, highly resilient story.

Barring neurological conditions such as stroke or dementia, most older adults retain excellent language skills. In fact, many individuals experience linguistic improvement as they accumulate a richer vocabulary throughout their lives.

A newly published brain imaging study—a collaboration between researchers at MIT and Boston University—has finally uncovered the neural mechanisms behind this phenomenon.

By analyzing the brains of older and younger adults, scientists discovered that activity in the brain’s language processing network remains remarkably stable as we age. When performing language tasks, older adults exhibited neural activation patterns almost completely identical to those seen in younger adults.

“In the language network, we couldn’t find any differences between older and younger groups,” says Anne Billot, a lead author of the study and currently a postdoc at Harvard University. “In contrast, the executive system showed decline across almost all of the measures. The network synchronization declined in older adults, the extent of activation was reduced, and the magnitude of activation was reduced as well.”

The research team divided participants into two cohorts: a younger group (ages 17–39) and an older group (ages 41–80). The participants engaged in carefully designed tasks to isolate two distinct brain systems: the “multiple demand network” (responsible for flexible problem solving and executive control) and the language network.

To trigger the multiple demand network, participants performed a spatial memory task where they had to remember the location of squares in a grid. As expected, older adults displayed weaker, less synchronized activation in these frontal and parietal brain regions compared to younger participants.

However, when subjects listened to stories and read sentences to trigger the language network, the results were strikingly different. Both younger and older adults demonstrated equivalent levels of spatial distribution and neural activity. When encountering unusual grammar or unfamiliar words, both groups showed the same spike in sensitivity and heightened neural response.

“We have previously used similar kinds of materials to show that young adults show strong sensitivity to these points of linguistic difficulty: activity in the language areas goes up. Here we found that in older adults, you also see this sensitivity, which suggests that there’s nothing fundamentally different about how they process language,” explains Evelina Fedorenko, an MIT associate professor of brain and cognitive sciences and senior co-author of the study.

Unlike the multiple demand network, which operates as a flexible, general-purpose resource vulnerable to aging, the language network specializes in accumulating knowledge.

“Vocabulary keeps increasing as long as people have been measuring, which makes sense. People get exposed to more and more language, and older people sometimes start reading more, so they get an extra boost — it’s like a large language model trained on increasingly more data,” Fedorenko notes.

These findings suggest that highly specialized regions of the brain may be fundamentally shielded from the normal wear and tear of aging, preserving our ability to communicate effectively throughout our entire lifespan.

Editorial Notes:

• This article was edited by a Neuroscience News editor.
• Journal paper reviewed in full.
• Additional context added by our staff.

About this Aging Research:

• Author / Media Contact: Sarah McDonnell
• Source: Massachusetts Institute of Technology (MIT)
• Contact Info: Sarah McDonnell
• Image Credit: Neuroscience News
• Original Research: Open access. “Preserved topography, lateralization, selectivity, and functional connectivity of the language network in older brains” by Anne Billot, Niharika Jhingan, Swathi Kiran, Evelina Fedorenko, et al. Nature Communications. Published August 24, 2026.
• https://doi.org/10.1038/s41467-026-76598-x

Immersive virtual reality to improve balance and gait after stroke: a pilot randomized controlled trial

 You somehow think your hospital is competent enough to bring this in when they can't even get you music therapy!

And they should have working on getting this in years ago! You'll need to reconstitute the whole hospital, it is beyond repair!

• immersive virtual reality (23 posts to January 2021)

Immersive virtual reality to improve balance and gait after stroke: a pilot randomized controlled trial

• Sauvage Chloé,
• Cabaraux Pierre,
• Rivas Lopez Luana,
• Therasse Anaëlle,
• Garbusinski Johanne &
• Baudry Stéphane 

We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.

Abstract

Background

Immersive virtual reality therapy (VRT) is emerging as a promising tool for stroke rehabilitation, with evidence suggesting benefits for motor recovery. However, its specific impact on balance and gait, particularly in the subacute phase of stroke in clinical setting, remains insufficiently explored.

Objective

The primary objective was to determine whether integrating a VRT program into conventional therapy improves balance more effectively than conventional therapy alone in persons with subacute stroke. Balance was assessed using the Berg Balance Scale, complemented by the Sensory Organization Test to explore changes in sensory contributions to postural control. Secondary objectives were to evaluate the effects of VRT on gait performance and to assess usability, patient satisfaction, and potential adverse effects, such as cybersickness, associated with VRT.

Methods

This pilot pragmatic randomized controlled trial included thirty-four participants who were equally randomized to a CT-only group and to a group in which 20% of daily CT was replaced by VRT. Both groups received the same total therapy time over a 2-weeks intervention. Functional ambulation classification, 2-min walking test, 10-m walking test, Berg Balance Scale (BBS) were assessed at baseline (T0) and post-intervention (T1). Sensory reweighting in the VRT group was evaluated with the Sensory Organization Test (SOT) at T0 and T1. Group, time and interaction effects were analyzed using ANOVA with post-hoc tests when appropriate. Spearman correlations were performed to assess relationships between improvements in gait and balance and sensory scores.

Results

Both groups improved significantly over time on all outcomes (p < 0.001), with no main group effect (p > 0.05). A significant group × time interaction was found for the BBS (p = 0.023), with greater improvement in VRT than in CT group. In VRT group, BBS improvement significantly correlated with the visual score of the SOT (r = 0.544, p = 0.030).

Conclusion

Adding VRT to CT in the subacute phase after stroke appears as an adjuvant to CT for improving functional balance, as reflected by greater gains in the Berg Balance Scale, and inducing changes in sensory integration processes.

Trail registration: ClinicalTrials.gov, TRN: NCT07409116, Registration date: 06 February 2026.

The No. 1 fruit to eat for longevity, according to a healthy aging researcher

 

How many berries are you getting in the hospital? None IS PURE INCOMPETENCE! Which means your board of directors is totally fucking incompetent in running a stroke hospital!

I had none except when Mom brought strawberries(Yes, strawberries do contain anthocyanins. These natural pigments give the fruit its bright red color and act as antioxidants)

The No. 1 fruit to eat for longevity, according to a healthy aging researcher

When it comes to longevity, what we eat every day plays a major role. Diet is has the potential to promote healthy aging and extend our "healthspan," or the number of years spent living in good health.

But the average healthspan in the United States is shrinking. More than three quarters of Americans have at least one chronic disease, such as heart disease, cancer or diabetes — a significant increase from the decade prior.

There's growing evidence that eating more nutritious, plant-based foods and limiting less healthy, processed foods can help prevent of chronic diseases and promote healthy aging, Emily Johnston, Ph.D., a research professor at NYU Langone specializing in longevity and nutrition, tells TODAY.com.

Fresh fruits and vegetables are a “non-negotiable" to live a longer, healthier life, she says.

Johnston previously shared the top fruits to support longevity, but one in particular reigns supreme for its beneficial nutrients.

Longevity Tip of The Day: Eat Berries Regularly to Promote Healthy Aging

Berries are the best fruit to eat for healthy aging, according to Johnston. "I always prioritize berries, every single day," she says.

Blueberries, raspberries, strawberries and blackberries are all excellent choices.

Blueberries often top the list of healthiest berries due to their high antioxidant content, but you can't go wrong with any berry, says Johnston.

The more berries, the better.

Why It Matters

These small but mighty superfoods are packed with beneficial nutrients, including fiber, vitamins, minerals and antioxidants.

The gut-healthy fiber in berries is a star nutrient for healthy aging. Fiber can aid with digestion, stabilize blood sugar, lower cholesterol, and reduce the risk of heart disease and colon cancer, which is on the rise.

Berries are especially rich in phytochemicals, like flavonoids, which have potent anti-inflammatory effects in the body and help protect heart and brain health. There's evidence that eating berries regularly in mid-life can improve cognitive function and lower dementia risk.

Most berries contain immune-boosting vitamin C and vitamin K, which supports healthy blood clotting, along with essential minerals like potassium and magnesium.

Berries also provide sweetness thanks to their natural sugars, making them an excellent alternative to added sugar, which most Americans eat too much of, per the American Heart Association.

How to Get Started

Berries are versatile, delicious and easy to sprinkle into your diet. Johnston recommends eating a variety of berries (and all fruits) daily to get a range of beneficial nutrients.

Aim to eat at least five servings a day of fruit and vegetables, along with lean proteins, healthy fats and whole grains.

Enjoy berries for breakfast on top of yogurt or oatmeal, blended into smoothies, sprinkled onto salads, as a snack, or as a naturally sweet dessert.

TODAY’s Expert Tip of the Day series is all about simple strategies to make life a little easier. Every Monday through Friday, different qualified experts share their best advice on diet, fitness, heart health, mental wellness and more.

This article was originally published on TODAY.com

Want to live longer? Experts say these 9 superfoods belong on your plate

 Are they in your diet protocol at the hospital? NO? So, INCOMPETENCE REIGNS! Do something about it! Like replacing the incompetent board of directors!

Want to live longer? Experts say these 9 superfoods belong on your plate

The secret to aging well might already be in your kitchen.

What we eat has a powerful influence on how we age. The right nutrients can boost energy, protect against chronic disease, and keep our bodies and minds strong. There’s no single “longevity diet,” but some foods are rich in compounds that support cellular health and help slow the effects of aging. With expert insights from dietitians, we’re highlighting nine superfoods that may help you add more healthy years to your life.

Meet the Experts

• Lena Bakovic, MS, RDN, CNSC, registered dietitian nutritionist
• Trista K. Best, MPH, RD, LD, registered dietitian
• Dru Rosales, MS, RD, LD, registered dietitian

How Superfoods Support Longevity

Celebrated for packing a powerful nutrient punch in every bite, superfoods are a smart way to upgrade your diet with disease-fighting compounds. These foods deliver a variety of essential vitamins, minerals, and antioxidants that help maintain energy, strength, and overall well-being as we age. “While there is no recognized definition of a superfood, most foods earn that title thanks to their antioxidant content, disease risk reduction potential, fatty acid profile, and/or high fiber content,” explains registered dietitian Dru Rosales, MS, RD, LD. “All of these benefits can lead to improved overall health, which becomes even more important as we get older and more susceptible to disease.”

01 of 09

Kimchi

Aside from its high probiotic content, kimchi also contains antioxidants, fiber, and a mix of key nutrients like vitamins A and C, plus minerals such as iron and potassium. The probiotics help support a healthy gut microbiome, which registered dietitian nutritionist Lena Bakovic, MS, RDN, CNSC, says plays a big role in reducing inflammation, strengthening immunity, and even influencing mood. “Furthermore, the antioxidants and vitamins A and C in kimchi help to contest oxidative stress, supporting the prevention of chronic diseases, and thus potentially contributing to longevity,” she adds. To preserve those beneficial probiotics, enjoy kimchi in its raw fermented form, as a zesty side, sandwich topper, or even tossed into salads.

02 of 09

Turmeric Powder

Research has linked regular curcumin intake, the powerhouse compound that gives turmeric its golden hue, to a range of impressive health benefits. Thanks to its antioxidant and anti-inflammatory properties, curcumin may help manage or even prevent conditions like multiple sclerosis, arthritis, epilepsy, and certain cancers by neutralizing harmful free radicals. It may also offer protection against cognitive decline, like Alzheimer’s. “Since curcumin is absorbed best when paired with black pepper, it’s smart to combine turmeric powder with pepper when cooking to maximize its benefits,” says Rosales.

Blueberries

Just one cup of fresh blueberries delivers a solid boost of vitamin C, vitamin K, and manganese. But what really makes blueberries shine is their high concentration of anthocyanins, the natural plant compounds that give them their deep blue color. “Studies have linked higher anthocyanin intake with a 25% to 32% reduction in heart attack risk, less weight gain over time, and a 26% lower risk for type 2 diabetes,” says Rosales, highlighting the antioxidant’s impressive health perks.

Avocado

Loaded with heart-healthy monounsaturated fats like oleic acid, avocados also deliver a hearty dose of dietary fiber and a range of micronutrients, including fat-soluble vitamins E and K, B vitamins, and potassium. “The monounsaturated fats in avocados work in helping to reduce LDL ‘lousy’ cholesterol levels, thus supporting cardiovascular health,” explains Bakovic. “Antioxidant vitamins like E and C in avocados help to combat oxidative stress, protecting cellular integrity, and potentially supporting skin health.”

Spinach

This leafy green is loaded with fiber to support gut health and contains key nutrients like iron, magnesium, manganese, and vitamins A and C. “The antioxidants in spinach, namely lutein and zeaxanthin, are beneficial for eye health and can help reduce the risk of age-related macular degeneration,” adds Bakovic, noting that these same compounds may also support cognitive function, which is especially important as we age. To get the most out of spinach’s iron content, strategic food pairing is key. “Because of its iron content, if paired with a whole food high in vitamin C such as a citrus fruit or bell pepper, the nutrient absorption of both iron and vitamin C within these foods will be synergistically enhanced,” says Bakovic.

Kale

Kale earns its superfood status thanks to an impressive lineup of essential nutrients that help protect cells from oxidative stress and maintain vital body functions. “Vitamins A, C, and K contribute to immune health, collagen synthesis, and bone strength—key factors in preventing age-related decline,” says registered dietitian Trista K. Best, MPH, RD, LD. Kale also delivers manganese, a mineral that supports metabolism and antioxidant defenses, along with moderate amounts of calcium, potassium, and magnesium, all crucial for heart health, muscle function, and maintaining bone density as we age.

Related: Which Is Healthier, Kale or Spinach? Nutrition Experts Settle the Debate

Lentils

Lentils‘ impressive nutrient profile includes folate, iron, and key minerals like magnesium, potassium, and zinc, along with antioxidants and polyphenols, which work together to reduce inflammation, support heart health, maintain muscle mass, and lower the risk of chronic diseases. “The high fiber content helps lower cholesterol and stabilize blood sugar, while the plant-based protein aids muscle preservation as we age,” says Best. She also notes that folate and iron are essential for maintaining healthy blood and energy levels, reducing fatigue, and supporting cognitive function. “Antioxidants and minerals like magnesium and zinc help combat inflammation and oxidative stress, both of which contribute to age-related decline.”

For the best results, try soaking lentils before cooking, which reduces cooking time and enhances nutrient absorption. “Avoid overcooking, which can break down some nutrients and reduce texture and flavor,” Best advises.

Chia Seeds

Packed with fiber, omega-3 fatty acids, protein and a healthy dose of calcium, magnesium, and antioxidants, chia seeds support longevity and healthy aging by promoting heart health, reducing inflammation, and maintaining strong bones. “The high fiber content aids digestion and helps stabilize blood sugar levels, lowering the risk of chronic conditions like diabetes,” explains Best. “Calcium and magnesium strengthen bones, while antioxidants protect cells from oxidative stress, a major contributor to aging and age-related diseases.” Toss them over yogurt, blend them into smoothies, or let them soak into your favorite overnight oats for a simple nutrient boost.

Queen’s North Hawaii launches stroke support group

 Complete admission THAT YOU ARE A MASSIVE FUCKING FAILURE AT 100% RECOVERY FOR SURVIVORS! Will your incompetent board of directors at least reconstitute the hospital with the correct objective? 100% recovery for all is the only goal in stroke!

Queen’s North Hawaii launches stroke support group

HAWAII ISLAND (HawaiiNewsNow) - Queen’s North Hawaii Community Hospital is launching a new support group for stroke survivors and their caregivers.

The free group will meet every other month and offer education, open discussions, practical recovery tools and guest speakers to help participants navigate life after a stroke.

Hospital officials said the first meeting is scheduled for Tuesday, July 21, from 5 p.m. to 6 p.m. in the Mauna Kea-Mauna Loa conference room at Queen’s North Hawaiʻi Community Hospital.

The sessions will be led by speech-language pathologist Amy Shipley of the hospital’s Rehabilitation Services Department.

“The stroke support group is all about supporting the families and people who are in recovery from stroke,” Shipley said. “Having an informal meeting where people can discuss the triumphs and hardships and nuances of recovery is really important.”

The support group is free and open to the public, and no registration is required.

For questions, contact ashipley@queens.org or call 808-881-4814.

Evaluating upper limb movement smoothness metrics derived from markerless 3D motion tracking in children with neurological disorders

 If this doesn't get in your hospital in the next month to objectively determine your recovery protocol needs; THEN EVERYONE IS MASSIVELY INCOMPETENT!

You need to get them all fired and the hospital reconstituted! Obviously no one in your hospital has any brains at all if this doesn't immediately trigger; 'Let's get this for stroke rehab.'

Evaluating upper limb movement smoothness metrics derived from markerless 3D motion tracking in children with neurological disorders

• Nikolas Hesse,
• Jan Lieber &
• Hubertus J. A. van Hedel 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Clinical assessment of movement smoothness during reaching in children is often based on subjective, ordinal-scaled therapist ratings. Markerless 3D motion tracking using an RGB-D camera offers a promising avenue for more objective and fine-grained smoothness evaluation. This study investigated the use of a new markerless RGB-D-based tracking method, SMPLify-KiDS, for the quantitative assessment of upper limb movement smoothness in a heterogeneous population of children with neurological impairments.

Methods

Thirty-eight children with neurological diagnoses performed three reaching tasks from the Melbourne Assessment 2 (MA2) MA2 with their more affected arm while being recorded with an RGB-D camera. Upper limb kinematics were extracted using SMPLify-KiDS, and two widely used smoothness metrics—the log dimensionless jerk (LDJ) and the modified spectral arc length (SPARC)—were computed. The same movement sequences were independently scored by two therapists according to MA2 guidelines. Correlations between quantitative smoothness metrics and therapist scores were evaluated using Spearman’s rank correlation coefficient, and smoothness metric differences between ordinal therapist score levels were analyzed using non-parametric statistical tests for individual items and averaged values.

Results

Quantitative smoothness metrics showed moderate to strong correlations with therapist scores per item (for LDJ:0.666 ≤ p ≤ 0.836; for SPARC:0.556 ≤ p ≤ 0.674  ), and very strong to excellent correlations for averaged values (for LDJ: p= 0.843, for SPARC:p= 0.755). Both metrics revealed statistically significant differences between ordinal therapist score levels, and LDJ strongly correlated with task duration.

Conclusions

Smoothness metrics derived from markerless RGB-D motion tracking are able to discriminate between clinically assigned smoothness levels in children with neurological impairments. LDJ showed closer alignment with therapist scores than SPARC, potentially due to its relationship with movement duration—a factor that also appears relevant to clinical perception of smoothness. These findings support the integration of markerless motion capture into clinical assessments to provide objective, quantitative, and fine-grained information on movement quality, complementing established therapist-based evaluations.

14 Foods That Protect Gut Health and Slow Biological Aging by Super Age

 Will your competent? doctor get the dietician to evaluate all the hospital meals for compliance? NO?  Which means your whole hospital is incompetent and needs to be reconstituted! 

14 Foods That Protect Gut Health and Slow Biological Aging

5 Simple Exercises To Build Ankle Strength—and Why It Matters for Your Fitness Routine

 Your competent? doctor did give you ankle exercises to prevent ankle rolling post stroke, right! Oh No, you DON'T have a functioning stroke doctor, do you? And your board of directors is so incompetent they have NO standards for excellence in their hospital! Sounds like the hospital needs to be reconstituted! I use the BOSU ball for this purpose, round side down, more challenging but less likely to roll the ankle.

5 Simple Exercises To Build Ankle Strength—and Why It Matters for Your Fitness Routine

While ankle strength isn't typically a central training focus, it’s an important aspect of healthy movement patterns that affects your entire fitness routine and everyday life. Here are five exercises to build your ankle strength:

1. Single-Leg Balance Drill

NickyLloyd / Getty Images

Balance is one of the simplest—and most underrated—ways to build ankle stability. Your ankle relies heavily on proprioception (your body’s sense of position), and better balance improves joint awareness and reaction time.1

Here's how to do a single-leg balance drill:

(I've failed the one leg standing test of the Berg Balance Scale from the 

beginning, now 20 years later(age 70) I still fail.) 

Stand tall with your gaze forward.

1. Lift one leg so your knee is at 90 degrees and you’re balancing on one foot.
2. Hold the position for 30-60 seconds, and then switch sides. 

Tip: You can progress the exercises by closing your eyes, turning your head, or standing on an unstable surface like a foam pad.

2. Calf Raises

Video at link.

A staple for ankle stability and strength, this movement trains your calf muscles, which support the ankle joint and play a key role in walking, running, and jumping. It’s best to do these slowly and controlled so you get full activation.2

Here's how to do a calf raise:

1. Keep your feet shoulder-width apart and create a slight arch with each foot by pressing your big toe into the floor.
2. With equal toe pressure, lift your heels off the ground as high as you can.
3. Pause for a moment at the top and feel the contraction.
4. Slowly lower with control before completing more reps.

Tip: The next step is to add more resistance to progress this exercise. Hold dumbbells in your hands for a bigger challenge. 

3. Tibialis Raises (Wall-Supported)

This exercise works the front of your shins, called the tibialis muscle, which is just as important as your other calf muscles for ankle stability. Each step or landing requires your ankle to control how your foot lowers to the ground, which is driven by the tibialis anterior. When it’s weak, the foot drops uncontrollably and increases stress on the ankle. Stronger tibs create smoother, more stable landings.3

Here's how to do a wall-supported tibialis raise:

1. Lean your back against a wall with heels about 6–12 inches away. 
2. With control, lift your toes toward your shins as high as you can.
3. Pause at the top, feel the contraction, and slowly lower. 
4. Do as many reps as you can until you notice you can’t lift as high during the next rep.

Tip: Progress it by inching your feet further away from the wall. 

4. Step-Down Control Drill

Alexandr Sherstobitov / Getty Images

This drill strengthens the ankle through loaded dorsiflexion (when your foot and shin move closer together), which is how your body actually uses the joint during movements like walking, running, and squatting. It also reinforces proper alignment—training your knee, ankle, and foot to work together, which is essential for healthy movement patterns. 4

Here's how to do a step-down control drill:

1. Stand on a step while creating a slight arch with your foot and maintaining big toe pressure. 
2. Slowly lower one heel toward the ground as you step off the box.
3. Once you land, step back onto the box and repeat the slow descent back down for more reps.

Tip: Make sure to keep your knee tracking over your toes so it doesn't collapse inward. You can progress this exercise by holding weights in your hand or going even slower on the descent. 

5. Lateral Hops

Video at link.

A more advanced drill, this plyometric exercise trains ankle stability through explosive movement driven by a coordinated effort of your strength, speed, balance, and reaction time.

Functionally, lateral hops train the ankle to rapidly absorb and reapply force, especially in the side-to-side direction where most ankle sprains occur. They improve reactive stability, meaning your ankle can quickly adjust to unexpected shifts in position, like stepping on uneven ground or quickly changing directions. 5

Here's how to do lateral hops: (This is totally impossible for me, I have never been able to jump since stroke)

1. Stand with your feet shoulder-width apart and your core tight.
2. In a coordinated effort, explosively hop to the side by bouncing off your toes while keeping your arches engaged as best as possible to prevent your knees from collapsing inward.
3. When you land, immediately hop back to the starting position from your toes and repeat in a dynamic fashion, making sure to land softly and with bounce.

Tip: If you find the explosive side-to-side movement too much, you can practice hopping to the side and sticking the landing each time. Reset and then hop back in the other direction. As you get more comfortable, you can start doing it faster and eventually with shorter ground contact time. 

Why It's Good To Have Strong Ankles

Strong ankles improve balance, power, and injury resilience. Weak ankles, on the other hand, can contribute to instability, poor movement mechanics, and a higher risk of sprains or overuse injuries. Whether you’re walking, lifting, running, jumping, or doing HIIT, ankle strength is foundational.6