Many abnormalities of balance are due to a loss of coordination between the inner ears and the eyes. Your ability to fix your eyes on a target while moving your head is critical to good balance. Your vision is critical to this reflex working properly, so be sure that your glasses or corrective lenses are appropriate for your vision. Often, progressive lenses or bifocals can make these conditions worse.
What is Vestibular Rehabilitation?
There are three basic concepts of vestibular rehabilitation. The first aspect deals with head-eye coordination exercises which help the eye-ear reflex work in a coordinated manner. It also stimulates the balance portion of the ear. It is critical that the head turn separately from the rest of your body in order for the ear to receive proper inputs. The second process involves balance retraining exercises which help to reduce unsteadiness and imbalance, by utilizing your vision, sensory system and postural system more effectively. The third aspect deals with habituation. In other words, continually repeating the actions that bring on the sense of dizziness or vertigo will eventually accustom the body to those actions. The exercises included below are those that we offer to patients for use at home. Where there is a chance of falling, we urge you to have a spotter next to you who is stable, and who could support you if you begin to lose your balance. Often people experience increased dizziness shortly after starting a vestibular therapy program. This can be considered a sign that the brain is appropriately reacting. Please use caution while doing these exercises, especially those that require you to stand (Ankle Sways, Ball Diagonals and Gait With Head Movement).
****These exercises should be performed 2-3 times a day.****
1. Focusing with Head Turns (Repeat 15-20 times)
Purpose of Activity: This activity will help you stabilize your gaze with quick, short head movements. This type of movement is used while driving.
2. Horizontal and Diagonal Head Movements (Repeat 15-20 times)
Purpose of Activity: This activity will help you keep your vision stable with head movements. This is similar to watching for a break in traffic.
3. Ankle Sways
Purpose of Activity: This activity will help you build good strategies for keeping your balance while standing. To improve use of your sensory system, actively grip the ground with your toes keeping your weight centered under the balls of your feet. (similar to a monkey gripping the tree branch)
Stand approx. 4 inches in front of the kitchen counter.
4. Ball Diagonals
Purpose of Activity: This activity will help strengthen the eye-ear reflex, and assist in retraining you to move your body and maintain your balance.
5. Gait with a Focal Point
Purpose of Activity: This will help you utilize visual information while walking to prevent staggering or loss of balance.
Have a focal point approximately 20 feet in front of you at eye level. As you begin walking keep eyes focused on target in front of you. Periodically briefly look down toward the floor (approx. 5 ft. in front of you) to check for obstacles and then return eyes to the target. A hallway is an excellent place for this activity in the beginning.
6. Gait with Head Turns
Purpose of Activity: This activity will help you build stable head movements while walking. This type of movement occurs when walking down the aisle of the grocery store searching for an object.