Vestibular Exercises

Otolaryngology-Head and Neck Surgery
Vestibular Exercise Program to Overcome Dizziness

AIMS OF EXERCISE:

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

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

To practice balancing in everyday situations with special attention to developing the use of the eyes and the muscle senses.

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

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

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.

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