What happens in the exercise program?
The treatment of a patient with inner ear disorders focuses on improving balance function, decreasing dizziness symptoms through vestibular habituation exercises, and increasing overall activity levels for long-term retention of gains made in therapy. In some instances, a patient may receive only vestibular habituation exercises if balance function is not affected.
Vestibular habituation exercises: Successful remediation of dizziness is dependent on determining the specific movements and/or positions that provoke the patient's dizziness or vertigo. These exercises are based on the rationale that through repeated exposure to the specific stimulus causing the vertigo, the brain will habituate or attenuate the vertigo response. The patient is asked to keep a daily diary logging frequency of exercise and noting changes in symptoms.
Balance retraining exercises: Balance retraining involves exercises designed to improve coordination of muscle responses as well as the organization of sensory information for balance control. Again, the emphasis is on a home program of exercise including gradual involvement in a daily aerobic exercise activity such as walking or biking to insure the patient maintains improvements.
VOR stimulation exercises
VOR stimulation exercises are performed to improve the gain of the VOR.
- Head movements in phase with target: Hold a card with lettering at arm's length with eyes focused on the letters. Move the head from side to side, increasing speed with progressions. Repeat the entire cycle 20-30 times. The head also can be moved vertically and diagonally. Progress from sitting to standing with the feet shoulder width apart to standing with the feet together to standing partially pointed (ie, one foot half way ahead of the other) to standing pointed (ie, one foot completely in front of the other). Progress from standing on a firm surface to standing on a compliant surface. Post the card on the wall with a plain background and progress to posting on a wall with a busy patterned background.
Head movement out of phase with target: Hold a card with lettering at arm's length with eyes focused on the letters. Move the head to the right and the card to the left, keeping the eyes focused on the letters. Then move the head to the left and the card to the right, keeping the eyes focused on the letters. Begin slowly and increase speed as the test progresses, but keep the letters in focus. Repeat the entire cycle 20-30 times. This test also can be performed in a vertical direction. Progress from sitting to standing to a sharpened stance as described above.
|
