Your doctor has determined that you have a balance problem that may improve with a rehabilitation program. Head motion stimulates the balance canals of the inner ear. Like a figure skater just learning to spin on skates, you can expect it will take some time for your balance to improve. The brain must learn to overcome the feeling of dizziness. Virtually all patients using these exercises will note improved balance, but it may take a few weeks. DON’T GIVE UP! It is important to start slowly because quick head movements can make anyone lightheaded at first. Slowly increase the speed and duration of exercises as tolerated. It is common for people to become dizzy during some of these exercises; this is a required part of the healing process. As in athletics: no pain, no gain.
Cawthorne’s exercises should be carried out for 5 minutes, 10 times per day. You can expect dizziness when beginning; this feeling should lessen over time with repetition. Please be seated while doing them.
Eye Exercises: Look up, then down-at first slowly, then quickly 20 times. Look from one side to the other-at first slowly, then quickly 20 times. Try to focus on an object at the end of each head turn.
Head Exercises: With eyes open, bend head forward, then backwards--at first slowly, then quickly 20 times. Turn head from one side to the other--at first slowly, then quickly 20 times. As dizziness lessens, these head exercises should be done with the eyes closed.
Sitting/Bending: While sitting, shrug shoulders 20 times. Turn shoulders to the right, then to the left 20 times. Bend forward and pick up objects from the ground and sit up, 20 times.
Standing: Change from a sitting to standing position, and back again, 20 times. Do this initially with eyes open. As balance improves, do this with eyes closed (but only if you have a partner to help you). Throw a small rubber ball (or similar object) from hand to hand above eye level. Throw the object from hand to hand under one knee.
1. Begin in a sitting position. Choose an object on the wall, such as a clock or picture. Keep your eyes focused on the object from about 5 feet away. Turn your head to the right and left about 30 degrees, thus making the head motion like saying "no". Move the head like a grandfather clock or metronome. You should be turning right to left and then left to right about one time per second. Repeat this head turning 20 times per session.
2. Focus again on an object on the wall. This time move your head up and down, thus making the head motion like nodding "yes". Again perform one nod per second, and repeat 20 times.
These should be repeated 10 times a day as tolerated. MAKE SURE TO HAVE SOMEONE THERE TO CATCH YOU SHOULD YOU START TO FALL.
1. Stand on a soft (compressible) surface with your eyes open for one minute. Keep shifting your weight from your left leg to your right leg.
2. Stand on flat (firm) surface with your eyes open for one half minute. Rock back and forth about the ankle without bending at the hip.
3. Stand on a flat (firm) surface in a corner with your back against a wall. Keep your eyes closed for one minute.
4. In the corner, practice standing on your heels and then your toes with your eyes open for one half minute.
5. Walk across the room (with your partner) with eyes open, then again with them closed. Walk up and down steps with eyes open, then closed. Walk up and down a slope with eyes open, then closed. Perform these 10 times a day.
6. Try dancing carefully with a partner, performing frequent turns and bends. Any activity involving stooping or turning is generally good.