BALANCE THERAPY GUIDE - VESTIBULAR REHABILITATION

What is balance therapy?

This is a form of therapy used to treat problems caused by disorders of the vestibular system (the center of balance). Including vertigo and dizziness, gaze instability, and/or imbalance, and falls.

These 12 beginner exercises (seated, standing, and walking) will help you get back on your feet and help you get your life back. 

 

Start these every day, one time per day. If tolerable, add a second session, then the third session if time allows. Doing the gaze stabilization exercises up to 4 times per day is best for optimal improvement. 

 

It is normal for these exercises to make you feel dizzier but you shouldn't stay dizzy for the rest of the day. A good guideline for recovery is that any increase in dizziness you experience during the exercises should go away and your dizziness should return to your baseline within 20 minutes of completing the session. If the increase in dizziness lasts longer than 20 minutes, do fewer reps, fewer exercises, move slower, or otherwise decrease the number and intensity of the exercises until you recover within 20 minutes. Gradually build up again as you can. 

 

This is just a guideline - do more or less based on what feels tolerable for you. 

1 - Head nod without gaze fixation (seated)
  1. Start with the number of repetitions that you can do

  2. Increase gradually repetitions

  3. Goal: 20 repetitions 

2 - Head turn without gaze fixation (seated) 
  1. Start with the number of repetitions that you can do

  2. Increase gradually repetitions

  3. Goal: 20 repetitions 

 

 

3 - Gaze stabilization with head nods while seated

(your eyes might be focusing on one of your fingers or any small object located 2 small feet in front of you)

  1. Start with the number of repetitions that you can do

  2. Increase gradually repetitions

  3. Goal: 20 repetitions 

 

 

 

 

4 - Gaze stabilization with head turns while seated  

(your eyes might be focusing on one of your fingers or any small object located 2 small feet in front of you)

  1. Start with the number of repetitions that you can do

  2. Increase gradually repetitions

  3. Goal: 20 repetitions 

 

 

 

5- Seated VOR cancellation:

Lift your arm straight in front, focus your eyes on your finger,  and as you move your finger side to side follow your finger with your head 

  1. Go as far as you feel comfortable going and increase motion as you progress.

  2. Start with the number of repetitions that you can do

  3. Increase gradually repetitions

  4. Goal: 20 repetitions 

 

 

 

 

6 - Head tilt with EYES OPEN while seated

(try to not focus your eyes in any particular object) Tip your ear into your shoulder, make a pause, and back up, pause and repeat to the other side.

  1. Start with the number of repetitions that you can do

  2. Increase gradually repetitions

  3. Goal: 20 repetitions to each side

 

7 - Head tilt with EYES CLOSED while seated.

Tip your ear into your shoulder, make a pause, and back up, pause and proceed with the next side.

  1. Start with the number of repetitions that you can do

  2. Increase gradually repetitions

  3. Goal: 20 repetitions to each side

 

8 - Single leg balance 

(standing, not walking. Be sure you are standing next to a bookshelf or a countertop for support) 

  1. Start with the number of seconds that you can tolerate

  2. Increase gradually the time

  3. Goal: 30 seconds on each side 

 

9- Tandem stance

(tightrope standing not walking).

One foot right in front of the other (heel right in front of your toes) 

  1. Start with the number of seconds that you can tolerate

  2. Increase gradually the time

  3. Goal: 20 seconds standing on each side

 

 

10 - Walking with small head turns

(try not to focus your eyes on any particular object)

  1.  Goal: 100 feet 

11 - Walking with gaze stabilization and head turns.

Walk with your eyes targeting one finger in front of you (like the image but walking)

  1. Goal: 100 feet 

 

12 - Walking with VOR cancellation head turns.

Walk with your eyes targeting one finger moving side to side in front of you (like the image walking) 

  1. Goal: 100 feet 

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