Benign paroxysmal positional vertigo is an inner disorder that affects your vestibular system and inhibits your body's sense of position in relation to its surroundings. The Vestibular Disorders Association says, "During vestibular rehabilitation therapy, home exercises are a vital part of treatment." VEDA recommends that someone afflicted with BPPV should begin a personal treatment plan accompanied by appropriate exercises after a proper diagnosis is made by a vestibular specialist.
Canalith Repositioning
The Epley and Semont maneuvers were designed to shift inner ear debris to a less sensitive part of the ear canal. The Epley maneuver does this by systematically rotating the head in a series of postures, holding each for 30 seconds. In the Semont maneuver, the doctor has the patient lie down on one side for a time, then has her quickly switch to the other while holding the patient's head at a specific angle. Both procedures are to be administered by a doctor. Both may cause side effects associated with the disease and require supervision. Dr. Timothy C. Hain of the Northwestern University Medical School, says the office maneuvers are effective in 80 percent of patients with BPPV, although some may require multiple visits. Hain also says home Epley exercises may be prescribed by the doctor if the office maneuvers fail to produce results.
Brandt-Daroff Exercises
The Brandt-Daroff exercises were made to be performed by the patient at home with permission from a doctor. They are done from a sitting position on a bed or a couch. These exercises require the patient to switch positions, lying on one side, then the other with the head turned up at a 45-degree angle. Results are 90 percent effective for patients who repeat the program daily for at least 14 days.
Tai Chi
VEDA lists tai chi among the exercises that support vestibular rehabilitation. Tai chi focuses on the position of the trunk of the body in relation to the head and visual field while providing coordinated, slow-moving steps that stabilize the body. Tai chi reduces postural sway and strengthens the legs, ankles and core to create a more stable stance for those afflicted with BVVP. Check with your physician to see if tai chi is a safe option for your specific type of BVVP. As with any form of physical therapy, approach your goals slowly and take note if your BVVP symptoms worsen.
Wii Balance Programs
VEDA also advocates the use of balance building programs in Wii home game consoles. At the VEDA clinic in Portland, Oregon, patients use the Wii for vestibular rehabilitation after they have been treated for the more sensitive stages of vertigo. Patients create a profile on the system to chart improvement, then use the sensors in the Wii balance board to provide feedback while building body stabilization through games like "Tightrope Walk", "Table Tilt" and "Soccer Heading." Wii provides a safe environment for BVVP patients to work on ordinary balance skills in the clinic, or in their own home. Notable improvements were seen in patients' Dizziness Handicap Inventory score in less than four weeks.
References
- Vestibular Disorders Association: Home Based Exercise
- Vestibular Disorder Association: Using the Wii for Vestibular Rehabilitation; 2009
- Dizziness and Balance: Office Treatment of BPPV: The Epley and Semont Maneuvers
- "Archives of Otolaryngology"; Physical Therapy for Benign Paroxysmal Positional Vertigo; T. Brandt and R.B Daroff, 1980
- Vestibular Disorder Association: Improving Balance with Tai Chi; 2009
