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Vestibular Exercise Program To Overcome Dizziness

The document discusses vestibular rehabilitation therapy (VRT), an exercise-based program to promote central nervous system compensation for inner ear deficits related to balance. VRT can help with conditions like benign paroxysmal positional vertigo and reduced inner ear function. The exercises may initially cause increased symptoms but balance typically improves over time with correct and consistent practice. The exercises retrain the brain to compensate for vestibular dysfunction. Symptoms can return if the brain forgets what it has learned, requiring a return to the exercise program.

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842 views4 pages

Vestibular Exercise Program To Overcome Dizziness

The document discusses vestibular rehabilitation therapy (VRT), an exercise-based program to promote central nervous system compensation for inner ear deficits related to balance. VRT can help with conditions like benign paroxysmal positional vertigo and reduced inner ear function. The exercises may initially cause increased symptoms but balance typically improves over time with correct and consistent practice. The exercises retrain the brain to compensate for vestibular dysfunction. Symptoms can return if the brain forgets what it has learned, requiring a return to the exercise program.

Uploaded by

Abidin Zein
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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The form of treatment prescribed for vestibular disorders depends upon symptoms,

medical history and general health, diagnostic test results, and a physical
examination by a qualified doctor.

Vestibular Exercise Program to Overcome Dizziness


AIMS OF EXERCISE:
1. To loosen up the muscles of the neck and shoulders, to overcome the protective
muscular spasm and the tendency to move “in one piece.”

2. To train movement of the eyes, independent of the head.

3. To practice balancing in everyday situations with special attention to


developing the use of the eyes and the muscle senses.

4. To practice head movements that cause dizziness, and thus gradually overcome
the disability.

5. To become accustomed to moving about naturally in daylight and in the dark.

6. To encourage the restoration of self-confidence and easy spontaneous


movement.

All exercises are started in exaggerated slow time and gradually progress to more
rapid time. The rate of progression from the bed to sitting and then to the standing and
walking exercises depend upon the dizziness in each individual patient’s case.
A. SITTING POSITION – without armrests
1. Eye exercises – at first slowly, then quickly
a) Up and down.
b) Side to side.
c) Repeat a and b, focusing on finger at arm’s length.
2. Head exercises – head movements at first slow, then quick
3. Shrug shoulders and rotate, 20 times
4. Bend forward and pick up objects from the ground, 20 times
5. Rotate head and shoulders slowly, then fast, 20 times
6. Rotate head, shoulders and trunk with eyes open, then closed, 20 times
B. STANDING POSITION
7. Repeat Number 1
8. Repeat Number 2
9. Repeat Number 5
10. Move from a sitting to standing position, with eyes open, then closed.
11. Throw ball from hand to hand (above eye level)
12. Throw ball from hand to hand under knees
13. Move from sitting to standing, and turn around in between.
14. Repeat Number 6
C. WALKING
15. Walk across room with eyes open, then closed, 10 times
16. Walk up and down slope with eyes open, then closed, 10 times
17. Play any game involving stooping, or stretching and aiming, such as bowling,
shuffleboard, etc.
18. Stand on one foot with eyes open, then closed
19. Walk with one foot in front of the other with eyes open, then closed

Cawthorne’s Head Exercises


Exercises are to be carried out for 15 minutes twice a day, increasing to 30 minutes.

EYE EXERCISES
Look up, then down – at first slowly, then quickly, 20 times.
Look from one side to the other – at first slowly, then quickly, 20, times.
Focus on your thumb at arm’s length, moving it one foot toward you and back again,
20 times.
HEAD EXERCISES
Bend head forward then backward with eyes open – slowly, later quickly, 20 times.
Turn shoulders to right, then to left, 20 times.
Bend forward and pick up objects from the ground and sit up 20 times.
STANDING
Change from sitting to standing and back again, 20 times with eyes open. Repeat with
eyes closed.
Throw a small rubber ball from hand to hand above eye level. Throw ball from hand
to hand under one knee.
MOVING ABOUT
Walk across the room with eyes open, then closed, 10 times.
Walk up and down a slope with eyes open, then closed, 10 times.
Walk up and down steps with eyes open, then closed, 10 times.
Any game involving stooping or turning is good.

Vestibular rehabilitation therapy (VRT) is an exercise-based program designed


to promote central nervous system compensation for inner ear deficits. VRT can
help with a variety of vestibular problems, including benign paroxysmal positional
vertigo (BPPV) and the unilateral or bilateral vestibular hypofunction (reduced inner
ear function on one or both sides) associated with Ménière’s disease, labyrinthitis,
and vestibular neuritis.

Some of the exercise and activities may at first cause an increase in symptoms as
the body and brain attempt to sort out the new pattern of movements. Because of
this, people sometimes give up on VRT, thinking it is making their vestibular
disorder worse. However, in most cases balance improves over time if the exercises
are correctly and faithfully performed. Muscle tension, headaches, and fatigue will
diminish, and symptoms of dizziness, vertigo, and nausea will decrease or
disappear. Many times, VRT is so successful that no other treatment is required.

After the brain has learned to compensate for vestibular dysfunction, events such
as a bad cold or flu, minor surgery, or even anything that interrupts normal activity
for a few days can cause the brain to “forget” what it learned and symptoms to
reoccur. This is called decompensation. Most people are able to quickly recover
from decompensation by immediately returning to the home-based exercise
program developed during their initial course of VRT. However, if symptoms persist
or are severe, it is important to get a diagnosis and medical treatment because this
suggests that additional vestibular damage has occurred.

New Dizziness Therapy

If you suffered from dizziness, you were probably told, "You'll have to live with it."
That's not the case today.

Three sensory systems gather information regarding your body's position and movement in
space: the visual, vestibular (semicircular canals and otoliths), and somatosensory (touch, joint
and muscle receptors) systems. These systems transmit information to your brain's central
processor, the cerebellum.
The balance response is carried out by the motor system located here - the right and left
vestibular systems, which are key to maintaining balance because they provide the brain with
information about your head movement and position. Disease in one vestibular system will send
erroneous information to your brain and cause vertigo or imbalance.
Vision helps orient the body in space by referencing vertical and horizontal axes of objects
around you. The somatosensory system gives your brain information regarding support surfaces
and the motion of your body's parts in relation to one another.
Balance can be maintained if you suffer a loss of one of these three sensory systems, but when
more than one system is lost balance difficulties like dizziness occur. And this is where
vestibular rehabilitation comes in.
The vestibular system is housed in our middle ear near the cochlea that is
responsible for our balance. Most people stop there but in fact the strength of the
vestibular system affects how many of our sub-systems work such as
proprioception, sight and many others.

Three methods of vestibular rehabilitation: The first is habituation, which means


that by continually repeating the actions that bring on dizziness or vertigo you will
eventually accustom your body to those actions. The second process involves
balance retraining exercises that help reduce unsteadiness and imbalance. The
third aspect deals with head-eye coordination exercises that help reduce gaze-
induced dizziness.

A physician will diagnose your particular problem by performing a complete medical


history, a neurologic examination, and tests of hearing and balance function. Blood
tests for allergies, autoimmune inner ear disease (allergies to your own ear tissue),
or hormonal imbalance may also be necessary.

A vestibular rehabilitation therapist with create a therapy program specifically for


you.

Vestibular rehabilitation (VR) is a well-accepted exercise program intended to


remedy balance impairment caused by damage to the peripheral vestibular system.
Alternative therapies, such as Tai Chi (TC), have recently gained popularity as a
treatment for balance impairment. Citation: BMC neurology. 2005 Feb 18 ;5(1): 3.

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