Vestibular Exercises

1. Seated or in bed

a. Eye movements: move the eyes slowly at first, then quickly

i. Up and down
ii. Side to side
iv. Focus on a finger moving from 1 foot to 3 feet away from the face

b. Head movements: move the head slowly at first then quickly, with the eyes open

i. Bending forward and backward
ii. Turning from side to side
iii.Tilting from side to side
iv. Diagonal movements
v. Repeat with the eyes closed

c. Coordinate movements of both eyes and the head in the same direction, as in sections a and b

d. Shoulder shrugging and circling

e. Bending forward and picking up objects from the ground

2. Standing

a. Repeat Section 1 exercises while standing

b. Change from a sitting to a standing position, first with the eyes open, and then with the eyes closed

c. Throw a ball from hand to hand above the eye level

d. Throw a ball from hand to hand under the knees

e. Change from sitting to standing, turning first to one side and then the other

3. Moving about

a. Walk across the room with eyes open, and then with eyes closed

b. Walk up and down a slope with eyes open, and then with eyes closed

c. Walk up and down steps with eyes open, and then with eyes closed

d. Sit up and lie down in bed

e. Stand up and sit down on a chair

f. Recover balance when pushed in each direction

g. Throw and catch ball

h. Engage in any game involving stooping or stretching and aiming, such as bowling, volleyball, or shuffleboard

HOME EPLEY MANEUVER-For Benign Positional Vertigo

The Epley maneuvers can be done at home. We often recommend the homeEpley to our patients who have a clear diagnosis. This procedure seems to be even more effective than the in-office procedure, perhaps because it is repeated every night for a week. The method (for the left side) is performed as shown on the figure to the right. One stays in each of the supine (lying down) positions for 30 seconds, and in the sitting upright position (top) for 1 minute. Thus, once cycle takes 2 1/2 minutes. Typically 3 cycles are performed just prior to going to sleep. It is best to do them at night rather than in the morning or midday, as if one becomes dizzy following the exercises, then it can resolve while one is sleeping. The mirror image of this procedure is used for the right ear.