Objectives: To evaluate a training programme aimed at improving lateral weight transference in patients following acute stroke to determine main treatment effects, if any, to inform the design of future studies. Design: A single-blind randomized controlled trial. Setting: The Stroke Unit at The James Cook University Hospital, Middlesbrough, UK. Subjects: Thirty-five patients with an acute stroke. Interventions: All subjects received their usual care, including physiotherapy. The treatment group (n = 17) received 12 additional therapy sessions (over four weeks) comprising exercises aimed at improving lateral weight transference in sitting delivered by trained physiotherapy assistants. Main outcome measures: Measures of dynamic reaching, sitting and standing, and static standing balance were undertaken by a blind independent observer. Results: Specific measures of weight displacement in standing and reaching, and timed standing up and sitting down did not detect any differences over time regardless of group. Neither were there any significant changes over time, except for sway during static standing (p < 0.01) and time to return to their original position during dynamic reaching (p = 0.01). Conclusions: A training programme aimed at improving lateral weight transference did not appear to enhance the rehabilitation of acute stroke patients. Improvements observed in postural control in standing and sitting may be attributable to usual care or natural recovery.