BEFORE YOU PERFORM ANY EXERCISES – WHAT IS BPPV?
Benign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear that affects the body balance mechanism causing vertigo, but it definitely could be treated with special BPPV exercises.
Episodes of BPPV are triggered by changes in the position of head, including up and down movements along the neck axis, lying down, turning over and sitting up.
BPPV is one of the frequent types of vertigo encountered in clinical settings. The canalith repositioning procedure and surgical placement of a bone plug to block the afflicted portion of the inner ear are the available medical treatment options for BPPV.
Management of BPPV can also be done by various physical exercises.
Although Epley Maneuver and Semont maneuver are essentially physical exercises, they are exercises that carry some degree of medical risks and hence, done at the doctor’s place. They should be thus, treated as medical treatment procedures instead of physical exercises.
MANAGEMENT OF BPPV BY EXERCISE
Modified Epley Maneuver and Brandt-Daroff maneuver are examples of BPPV exercises.
Specific daily exercises have been designed for the management of BPPV. These exercises have been specially designed on the principle of repetitive stimulation of the inner ears intentionally to reproduce the vertigo sensation on a daily basis so that the body develops an enduring adaptation to the symptoms of a vertigo episode.
Most of these exercises are recommended to be done with the eyes open and on a bed to avoid falls. These exercise modules run a minimum of one session a day with a minimum of six exercises per session.
SIMPLE BPPV EXERCISES
Some simple exercises begin with the patient first sitting in bed with the eyes open and then quickly lying back straight on the bed keeping the eyes still open and then staring at a fixed object like an electric bulb on the ceiling for a short period of about ten seconds.
Upon onset of a vertigo symptom during such a physical maneuver, the patient is advised to hold on to the position until it stops.
When the patient is able to hold on successfully in this first step, the next step begins with the patient briskly sitting up and look for vertigo symptoms and hold on till it clears. The previous maneuver is then repeated immediately after this step.
Upon gaining confidence, the same two steps are repeated with the head turned to the right and then to the left.
THE BRANDT-DAROFF EXERCISES
The Brandt-Daroff exercises on the other hand are technically designed to disperse tiny particles that affect the balance mechanism in the human ear away from the balance centre thereby, eliminating the cause of vertigo.
The Brandt-Daroff exercise speeds up the compensation process that ends the symptoms of vertigo.
It is prescribed not only for people with benign paroxysmal positional vertigo (BPPV) but also sometimes for patients with labyrinthitis.
The exercise begins with the patient sitting on the edge of the bed, turning the head 45 degrees to the left and lying down quickly on the right side with the back of the head resting firmly on the bed.
Upon onset of a vertigo symptom during such a physical maneuver, the patient is advised to hold on to the position for about 30 seconds or until the vertigo symptoms die down.
When the patient is able to hold on successfully to this first step, the next step begins with the patient briskly sitting up, looking for vertigo symptoms and holding on for 30 seconds or until the vertigo symptoms die down.
The exercise is repeated by turning the head 45 degrees to the right and lying down quickly on the left side with the back of the head resting firmly on the bed. Usually, it is five times on each side and takes about ten minutes to complete. The exercise can bestow excellent improvement in the vertigo symptoms with a thrice in a day schedule.
It is imperative to mention that horizontal canal BPPV does not respond to such head exercise maneuvers. Forced Prolonged Positioning is a physician assisted maneuver and cannot be recommended as an exercise at home. For such horizontal canal BPPV cases, a therapist guided daily self-canalith repositioning exercise at home can be effective.
Episodes of BPPV can cause severe distress and discomfort. BPPV exercises are not only effective in the self-management of the syndrome but also safe with minimum risks of aggravation.
Using multiple pillows for sleeping, shunning sleeping with the face down, especially in the problematic ear on the down side, eschewing the habit of standing up suddenly from bed and being careful while in reclining positions can augment the process of BPPV recovery.