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Vestibular Rehab

Discussion in 'Your Living Room' started by imback, Feb 14, 2016.

  1. June-

    June- Well-Known Member

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    Ditto what redwing said.
     
  2. Robert Wilson

    Robert Wilson Member

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    I went to one PT that didn’t help me at all.

    Then, I found a good one that helped me a great deal. Central Texas. Tell me if you want the name.
     
  3. AnneT

    AnneT Well-Known Member

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    Thanks for the offer, Robert, but I’m in Calgary, Canada! But hey, if your good physio happens to have any recommendations for up here, let me know!
     
  4. Clare

    Clare Active Member

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    I found my vestibular physical therapist from the VEDA website.
     
  5. AnneT

    AnneT Well-Known Member

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    I just saw D’arcy Gainor (NW Calgary). He knows his stuff, but I’ll be his first gentamicin recovery case. He’s going to be really helpful, I think, in coaching me through very specific exercises, how often, the delicate balance of giving the brain enough challenge to learn but not tip me into doing too much too fast.

    I’m a little queasy after this first visit but can write more details later when I feel better.

    Tomorrow morning is my gentamicin injection.
     
  6. Clare

    Clare Active Member

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    I often felt a bit queasy after vestibular therapy. It lessened as the exercises progressed. Good luck tomorrow, Anne.
     
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  7. AnneT

    AnneT Well-Known Member

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    Ok, here are the initial exercises that my vestibular physiotherapist showed me.

    1. Sitting in a chair, sit up straight. Then quickly flop your head and torso towards the floor the left of your left knee. Hang out there for a bit. Then flop back up quickly to sitting. Repeat on right.

    2. Straighten your arms out in front of you, clasp hands together, with thumbs up. Stare at your thumbs, as you swing your arms (keep hands clasped) fully to the left and right, for 10x.

    3. Turn your head to the left and right, full range of motion, 10x.

    4. Hold a paper or book with printing in front of you, at eye height. Focus on some print, while turning your head left and right quickly (not full range of motion), as fast as you can while keeping the print in focus, for count of 10.

    5. Extend one arm straight out in front of you, hand in "thumbs up" position. With both eyes open, make the thumb "cover" something on the wall. Without moving your hand/thumb, focus on the thing on the wall, then focus on the thumb. Repeat x10.

    He had me choose which one was the easiest, and told me to do just that one. But I've used all of them.

    Further general instructions:

    Sit quietly, and rate how dizzy, off balance, queasy, etc you feel, out of 5 (0 being totally comfortable, 5 being the worst.) Then do the exercise to the extent that you feel only 1 point worse, then stop, and let it recuperate back to your starting number. It may take seconds or minutes. You don't want to overdo it and wind up stimulating the yuck, which can just make your brain more wired ("recruitment") to feeling gross.

    Repeat this for 12-20 minutes, 12x per day, for optimal benefit. (Prepare yourself to cope with some boredom!)

    Bonus info (has been super helpful to me during my recovery from gentamicin injection):

    When you are feeling off, either during these exercises, or doing regular life activities, you can recuperate faster by using your hands cupped around and above your eyes (like horse blinkers), to narrow down what you see, and look at something visually calm. Find de-cluttered areas in your home, or cover up visually busy places with a plain blanket.

    When beginning to walk outside again, use a cane, and choose visually calm areas - avoid walking beside traffic, flickering fences, low noise, avoid sensory overload etc. Wear a hat and sunglasses. Find places with benches so you can rest as soon as you feel nauseated or off, or just go a few minutes away from home and back. You can always repeat.

    The vestibular rehab creates heat, so use and ice pack on your face, neck and allow breezes on your limbs.
     
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  8. Saera

    Saera Active Member

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    This is awesome!!!! Thank you for posting!!
     
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  9. AnneT

    AnneT Well-Known Member

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    IMPORTANT CORRECTION

    Under Bonus info above... that should say 12-20 minutes total per day (not 12x per day)!

    I saw the physio again today and he gave me some new exercises. I’ll type them up soon.
     
  10. Pupper

    Pupper Active Member

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    After first VNS at rehab they had me doing a few things that weren't terribly boring.

    Buy some of those cornhole bean bags. Link below. Stand still. Hands at sides, out just a bit. Bag in one hand. Toss it to the other hand, in an arc over your head. Follow it with your eyes (with head movement) the whole way. Whole way, meaning, from hand to hand. You tend to start lazilly winging it. But should really focus bag from release to catch. Repeat back and forth. If you get good, try it with feet/legs together.

    Therapist walks behind as you walk forward. She throws bag over you and you have to catch it. You can only glimpse it for a 1/4 second before you have to react. You can do this by yourelf. Just stand still or walk, and toss bag from behind your back, and catch it with other in front. Try to get some good head movement in, cuz that's what it's all about. This excercise isn't as good without a helper, but it works well enough. Try and vary your tosses, so you're not catching it in same place every time.

    Cute therapist used to stand about 4 feet in front of me and just throw these bags on the floor and I'd have to pick them up and give them back to her. Then she'd throw them on the floor again. I asked her if she's just messing with me. She said no. But I think she was. I bet the women therapists came up with some "humiliate the guy" exercises and had a giggle about it. I passed on it the next time we met.

    One I came up with on my own. You just balance something like a broom, or tennis racquet, or golf club, etc on your finger. I set up a little obstacle course in my living room, so I had to balance the golf club on my finger as I maneuvered around the obstacles (chairs, shoe, table, etc.)

    I personally haven't benefited from any of my therapy. I still have head movement unsteadiness.

     
    Last edited: Aug 16, 2019
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  11. Bulldogs

    Bulldogs Well-Known Member

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    I have a love hate relationship with vestibular rehab....I don’t think it works unless the vestibular loss is permanent and static (meaning no more vertigo and the brain can fully and permanently compensate)

    When you have an attack it’s like starting over again every time. The brain is constantly in a state of flux and can never permanently compensate. You are always relearning/retraining after every attack.

    Just give me the laby and make it permanent and static and vestibular rehab will work forever. The brain is amazing it will adapt.

    Just my opinion.... God Bless
     
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  12. Pupper

    Pupper Active Member

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    I guess links don't work. Anyway, you can go to Amazon and type in cornhole bean bags. I like the red and white stripes because you can see them so easy.

    I can't believe the game is called cornhole. Just learned that today. Seen people playing it forever.

     
    Last edited: Aug 16, 2019
  13. AnneT

    AnneT Well-Known Member

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    Thanks Pupper! I’ll try those exercises when I get bored of my current ones. I’m sure my sons will be happy to throw things at me

    Bulldogs
    I agree! I’m hoping that the 2 gentamicin shots have put me into the permanent vestibular loss situation and that everything will just keep getting better for me now. Your posts were a huge factor in my getting determined to slay the beast. I’m forever in your debt.
     
  14. Pupper

    Pupper Active Member

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    AnneT, have you posted a progress update since last week? I don't see one.
     
  15. AnneT

    AnneT Well-Known Member

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    Thanks for asking! Will do, over in my gentamicin thread.
     
  16. Nathan

    Nathan Well-Known Member

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    Subsurface ocean, Europa
    How dare you. Inordinate amounts of men & women walk the earth at this very moment, eager, if not desperate & fevered, to swiftly exchange large sums of money to retrieve the cornhole bean bags callously thrown about by attractive female medical practitioners.

    Upon your arrival at this "facility", Pupper, were you directed by a receptionist or bouncer?

    Asking for a friend.
     
  17. AnneT

    AnneT Well-Known Member

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    Bumping my July 18 post (and August correction!!) for Saera.
     
  18. AnneT

    AnneT Well-Known Member

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    More vestibular physiotherapy exercises from my dude:

    1. Walk down a hallway (street, etc), looking and focusing left for 3-4 steps, then right for 3-4 steps, etc.

    2. Stand in a doorway (for balance) with feet together, or tandem; eyes open or closed depending on how tough it is. He suggested that my compensatory movement should be coming from my ankles and knees, like a surfer - not out of my upper body, like I seem to do.

    (I'm trying! I told him that instruction, in my brain, is like telling me to look out the back of my head - it's just not there! He advised watching videos of surfers and snowboarders, and emulate. I find that if I just go ahead and start moving my knees, it seems to work... I think...)

    3. Walk heel-to-toe forwards, then backwards.

    4. Stand on a foam cushion (like off a couch). Stand straight, then let your body tilt forward until your toes grab the cushion.

    Again, all these for maybe 1-2 minutes each, and all the rehab for 12-20 minutes total per day. I'm doing 12 minutes in the morning, and then do a few more random acts of vestibular rehab throughout the day.
     
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  19. AnneT

    AnneT Well-Known Member

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    Internet based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice: three armed randomised controlled trial

    A good study of 322 adults over 50 years old with Chronic Vestibular Syndrome. Vestibular rehab, whether done through a physiotherapist, or from an online program, did better than usual care with GP - improvement on a vertigo symptom scale, less dizziness-related impairment, and less anxiety.

    I know VR won't stop vertigo attacks, but this is encouraging me to keep at my VR for the Meniere's and post-gentamicin dysequilibrium.
     
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  20. Megan Henry

    Megan Henry Member

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    My functional neurologist has me doing vestibular rehab. I believe it has helped substantially. It's a slow process and made me a lot worse in the beginning. I never knew looking back and forth at dots would make me feel like I would lose my lunch. I say try it. I'm very blessed that I do not have the full on rotational vertigo, just feel dizzy af all day. I can't speak to how it would work in that case. But imagine it could only help.
     
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