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Vestibular Compensation Exercises

Many conditions, such as vestibular neuritis, benign paroxysmal positional vertigo (BPPV), Ménière's disease, labyrinthitis, and peripheral vestibular disorders affect the inner ear's ability to maintain balance and perceive motion. With the help of a health professional, vestibular compensation exercises or vestibular rehabilitation therapy can help minimize the dizzying effects of such conditions by training the brain to use visual or proprioceptive information to maintain a sense of balance when the vestibular system no longer works properly.

  1. Canalith repositioning procedures (CRP)

    • Canalith repositioning procedures help reduce the feeling of dizziness by moving tiny particles that are stuck in a sensitive portion of the inner ear canal. With the help of a health professional, the patient completes a series of movements of the upper body and head. The Epley maneuver and the Semont maneuver are the two most commonly used CRPs. The Epley maneuver uses four 30-second position sequences of head movements. In the Semont maneuver, the patient is quickly moved from lying on one side to his other side. These CRP techniques are most often used with patients who have BPPV.

      Although the maneuvers have a high efficiency rate, they require a health professional: the intense, rapid nature of the movements carry a risk of serious injury if done incorrectly.

    Brandt-Daroff Exercises

    • Brandt-Daroff exercises are another type of CRP treatment. Because they are less intense, these exercises can be done at home without the supervision of a health professional. The exercise is easiest when sitting on the edge of a bed. The patient turns her head 45 degrees to one side, then quickly lies down on her opposite side. The back of her head (behind the ear) should rest on the bed for 30 seconds, before she returns to an upright sitting position. The exercise should be repeated, alternating right and left sides, for six repetitions. Like other CRP treatments, Brandt-Daroff exercises are frequently used for those with BPPV.

    Cawthorne-Cooksey Exercises

    • Cawthorne-Cooksey exercises consist of a variety of motions and techniques that teach the eyes to move independently of the rest of the head, and allow the patient to experience and acclimate to dizzying head movements. They also help the patient practice good balance, and ultimately eliminate the feeling of dizziness. A trained health professional can help the patient determine the exercises and number of repetitions that best suit their needs. A number of the exercises can be done while sitting, such as moving the eyes, shoulders, or head. Other exercises include changing from a sitting to standing position with eyes opened or closed, turning around, or throwing objects. Some exercises require the patient to walk around a room, up or down a slope or steps, or complete movements with their eyes either closed or opened.

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