Exercises to Prevent Vertigo
Benign paroxysmal positional vertigo is dizziness or a sensation of spinning when movement is not actually happening. It is attributed to the misplacement of calcium crystals in the inner ear that fool the brain into thinking the body is in motion. Exercises to prevent vertigo move those crystals around so that they no longer confuse the brain.
BPPV is sometimes treated through exercises that re-teach the brain how to balance the body. Other times, medication may be prescribed. However, both of these take time to be effective. Since the issue will likely clear up on its own within a few weeks, faster relief is preferred over that of balance retraining and medication.
Exercises that move the head around have been proven effective in BPPV relief. They are simple to do, but should be done with the assistance of a doctor or a therapist.
The Semont Maneuver
For this exercise, the patient should start on the side of a bed or examination table. With the assistance of a therapist, the head should be turned away from the affected ear until it is about halfway to the shoulder.
The therapist will help the patient lie down on his side with the affected ear. The head should be at the same angle as before so the patient can see the ceiling.
After two or three minutes, the therapist will move the patient back to the seated position and over on the other side of his body. The head does not change position, so the floor can now be seen. This position continues for another two or three minutes.
This should move the calcium crystals around enough to relieve the vertigo.
The Epley Maneuver
The patient starts seated in a vertical position with the head turned at a 45-degree angle toward the bad ear. The therapist will help him lean back until he is reclined on his back – the head remains at the same angle. A vertigo attack is likely at this point. This position is maintained until it goes away.
After that, the therapist will rotate the patient’s head 90-degrees to the opposite side. That position will be held for a minute or so to determine if another vertigo attack is happening. If not, or after recovery, the therapist will turn the patient farther in the same direction until the patient is on his side. The angle of the head should be unchanged and the face should be pointing at the floor. The check for vertigo is repeated and the position is maintained for a minute or two, or until recovery from the attack.
The patient then returns to a seated position with the head now tilted down for a minute or two. This should have moved the calcium crystals enough to relieve the vertigo. The exercise may be repeated if needed.
The Brandt-Daroff Exercise
The patient starts in a seated position on a bed. He then quickly inclines to the affected side until lying on his side. That position is maintained until a vertigo attack goes away, or for a minute or two. He then sits up quickly and pauses to check for vertigo. If there is an attack, the patient should wait until it subsides.
The same maneuver should now be done on the opposite side. Up to 20 daily repetitions of this exercise are recommended.
These exercises to prevent vertigo should only be done upon recommendation by a doctor or professional therapist. Precautions should be taken to avoid injury to the patient or someone else during these exercises.
American Academy of Otolaryngology