Vestibular neuritis exercises-various-aspects-
Vestibular neuritis exercises, typically included in vestibular rehabilitation therapy, focus on enhancing balance and minimizing dizziness by retraining the brain to adapt to changes in the vestibular system. These exercises consist of a mix of head and eye movements, walking patterns, and potentially habituation strategies.
Vestibular (Balance) Exercises
Introduction
You are experiencing issues with your balance or equilibrium. Do not let fear of your dizziness overwhelm you. Only you can develop the brain’s ability to manage your dizziness. It resembles a workout for building muscles. It necessitates consistent, capacity-enhancing effort to increase strength or tolerance. Continue to challenge your dizziness several times daily, understanding that each targeted, controlled episode of dizziness brings you closer to overcoming it. Once you achieve a significant level of improvement and control during your practice sessions, look for sports or other physical activities that have previously been challenging and gradually spend more time doing them until they cease to cause any symptoms.
How do vestibular exercises work?
These exercises aim to enhance the brain’s ability to compensate for injuries or inconsistencies within the vestibular or balance system. The brain processes information obtained from the vestibular or balance system. When there is an injury or anomaly in any part of this system, the brain needs to be retrained or taught to interpret the information it receives accurately. Vestibular exercises simply activate the vestibular apparatus. This activation provides data for the brain to process. The objective of repeating these exercises is for the brain to learn to endure and correctly interpret this type of stimulation. By consistently performing these exercises, one may even instruct the brain to adjust to an atypical stimulus. These exercises function similarly to the routines skaters or dancers perform to avoid becoming dizzy when rotating rapidly. In simple terms, an individual must confront and address those positions or circumstances that induce dizziness. Steering clear of them will merely extend one’s recovery time.
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Aims of exercises:
- 1.To facilitate the movement of the eyes, independent of the head.
- 2.To practice balancing in daily scenarios with a particular focus on enhancing the use of the eyes and the awareness of muscle sense.
- 3.To rehearse head movements that induce dizziness.
- 4.To acclimate to moving freely during both daylight and nighttime.
- 5.Overall, to promote the rebuilding of confidence in performing smooth, relaxed, spontaneous movements.
When you begin:
During the initial few instances of performing the exercise, it is advisable to have someone else present in case the dizziness becomes extremely intense.
When should you stop doing the exercise?
These exercises should be conducted at least three times daily for a duration of 6 to 12 weeks or until the dizziness completely resolves. Ceasing before the dizziness is entirely alleviated often leads to a recurrence of symptoms. The time to stop the exercises is when one experiences no dizziness for two consecutive weeks. The exercises can be paused and resumed at any moment if dizziness reappears.
The following exercises should be conducted two times each day. The exercises aim to test your balance system and may frequently induce symptoms of dizziness. This is a typical reaction to these stimulating exercises. You should attempt to push through these symptoms if it is feasible. If you believe you cannot, have your nurse reach out to an inpatient physical therapist for support.
Methods:
- Progress to performing each movement 20 times.
- All exercises begin at a noticeably slow pace and gradually increase in speed to a more swift rate.
- Make sure to persist with the exercises even when you feel dizzy. Take a break and rest only if you experience nausea or feel sick to your stomach. If unwell, after a rest, attempt a different exercise. If you still feel sick to your stomach, delay further work until your next session.
Head Exercises
1.Bending:
While seated, tilt your head down to gaze at the floor and then up to look at the ceiling.
- Guide your head with your eyes concentrating on the floor and the ceiling.
- Repeat this process 10 times. Stop and wait for symptoms to diminish, around 30 seconds.
- Repeat the entire process 2 more times.
2.Turning (side to side):
- While seated, turn your head to the right and then to the left, leading your head with your eyes as if you are observing a tennis match.
- Turn your head at a pace quick enough to evoke symptoms but not so fast that you hurt your neck. (Start slowly, then increase speed. )
- Go back and forth 10 times, and then wait for 30 seconds (or until symptoms improve).
- Repeat the entire process 2 more times.
As the dizziness lessens:
- Perform head exercises with your eyes shut.
- Progress to standing while executing head exercises.
The closer your feet are together, the more difficult it becomes.
Sitting
1.Shrug shoulders – 20 times.
2.Rotate shoulders to the right and then to the left – 20 times.
3.Rotate head, shoulders, and trunk – 20 times each:
- Rotate upper body right to left with eyes open, then repeat with eyes closed.
- Rotate upper body left to right with eyes open, then repeat with eyes closed.
4.Bend forward and touch the ground then sit back up. Keep your eyes focused on the wall – 20 times.
5.Bend forward and touch the ground then sit back up. Move your eyes to the floor and back – 20 times.
6.Eye movements (head is still):
- Up and down (focusing on a finger).
- Side to side (focusing on a finger).
- Finger to tip of the nose and out (focusing on a finger).
Standing
1.Change from a seated position to a standing position and back again
- 20 times with your eyes open.
- Repeat this with your eyes closed.
2.Standing with one foot in front of the other,
In a corner, practice standing “heel to toe” (one foot positioned in front of the other with the heel of one foot touching the toe of the other foot) with your eyes open for 30 seconds. The objective is to maintain your balance for the full 30 seconds without contacting the wall. You can increase the difficulty by crossing your arms over your chest. If this is initially too challenging, try standing “almost heel to toe” (with your feet touching at the big toes and ankles). After mastering this with eyes open, practice it with your eyes closed.
3.Standing on a cushion
- In a corner, stand on a couch cushion or multiple pillows. Attempt to remain still without leaning against the wall for 30 seconds. Practice this with your eyes open. Once this becomes easy, practice with your eyes closed. Increase the difficulty by bringing your feet closer together. Crossing your arms over your chest also heightens the challenge. You should advance by performing this in the most difficult position possible.
4.Standing and throwing
- Toss a small rubber ball from one hand to the other above eye level.
- Throw the ball from hand to hand beneath one knee.
5.Stand with your heels together
- Look straight ahead and maintain your balance (attempt this only with assistance).
6.Stand on one foot
- Try this first with your eyes open and then with your eyes closed (attempt this only with assistance).
7.Miscellaneous
- Engage in activities that involve stooping, stretching, bending, and going up and down stairs (this should be attempted only with assistance).
Walking
1.Walking in a straight line
- In a hallway or beside a wall, practice walking in a straight line for 5 minutes with one foot in front of the other or “heel to toe” (with the heel of one foot making contact with the toe of the other foot). If this proves too difficult at first, practice walking “almost heel to toe” and gradually progress to heel to toe touching.
2.Walking combined with head turning
- In a hallway or open space, practice walking in a straight line while rotating your head and eyes left and right with every other step (for example, when you step with your left foot, look left; when you step with your right foot, look right). Continue this for the length of the hallway or about 20 feet. Repeat the exercise 3 times. Now repeat the entire series another 3 times, this time looking at the ceiling or the floor. You should rest between repetitions to allow symptoms to settle.
3.Walk across the room
- First perform this with your eyes open, then with your eyes closed (attempt this only with assistance).
Lying Down
While sitting on the side of the bed, quickly lie down to your left side, swinging your feet onto the bed as you do so.
- Remain in this position for 30 seconds or until symptoms improve.
- Repeat this 3 times.
- Now repeat this 3 times to the right.
Eye Exercises – Gaze Stabilization Tips
- The target must stay focused, should not be blurry, and must appear stationary while the head is in motion.
- Perform exercises with slight head movement (45 degrees on each side).
- The speed of head movement should be increased as long as the target stays in focus.
- If you use glasses, wear them during the exercises.
- These exercises may induce dizziness or nausea. Attempt to work through these feelings.
- Rest after each exercise.
- Exercises require complete concentration. Minimize distractions.
- For safety, exercises done while standing should be carried out next to a counter or with someone nearby.
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Gaze Stabilization
Maintain your gaze on a single stationary target held in hand or located on a wall 3-10 feet away. Now move your head side to side for 30 seconds. Repeat this 3 times. Now repeat 3 times while moving your head up and down for 30 seconds. Complete 3 sessions daily. You may advance this by starting in a sitting position, then moving to standing with feet apart, standing with feet together, standing heel to toe, marching in place, or standing on a form. This will also become more challenging if the object you are focusing on is set against a “busy wallpaper” or a checkerboard pattern.
Smooth pursuit
While holding a single target, keep your eyes fixed on it. Gradually move the target side to side for 30 seconds while your head remains still. Perform this in a sitting position. Progress to standing as tolerated. Now repeat the movement with your head going up and down. Repeat 20 times in each direction per session. Complete 3 sessions each day.
Head and eyes in the same direction
While holding a single target (like a playing card or pencil), keep your eyes focused on it. Slowly move the target, along with your head and eyes, in the same direction (up and down, side to side) for 30 seconds. Perform this while seated, and you can progress to standing as you improve. Repeat 3 times per session. This will be more challenging if you have a “background” of busy wallpaper. Complete 3 sessions daily.
Head and eyes in the opposite direction
Holding your target, keep your gaze fixed on it and begin to slowly move the target (up and down, side to side) while moving your head in the opposite direction of the target for 30 seconds. Repeat this 3 times per session. You may advance from sitting to standing as in the earlier exercise. Complete 3 sessions each day.
Continue to perform these exercises at least twice daily until your symptoms subside. If these exercises do not elicit symptoms, you do not need to persist with them.
Initiate a walking program at home. Aim to walk 5 days a week. Start with a 5-minute walk. Gradually increase the walking duration by 5 minutes each week until you can walk continuously for 30 minutes.
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