Saturday 23 November 2013

Cawthorne-Cooksey Exercises










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Please note that the following is a general guideline/ discussion only. For a full assessment, exclusion of any other underlying cause for your symptoms and an individualised treatment approach, you will need to be seen by a qualified specialist.




The ears act as balance organs in space. This is similar to how two jet engines in either side of a plane keeps the plane steady. Misfiring can alter the flight leading to instability. In a similar way if the inner ears misfire you may feel dizzy.

Initial medications given are to suppress the misfiring ear thereby make on feel less dizzy. However the rehabilitation process is to maximise the residual inner ear function in the affected ear. During this process its is therefore important to stop any medication given to stop dizziness and nausea as stemetil.

Frequent repetition of the exercises will usually lead to more rapid improvement in the dizziness and impaired balance. One usually should continue these even once better. Other activities that may improve your symptoms are gentle safe exercises such as taichie, walking on soft sand if these are possible and if you are able to carry these out safely. You must have an able support person with with you always. If you feel unsafe avoid these activities.

The exercises should be carried out persistently for a total of at least 5 minutes, 3 times daily. You should not try to perform all the exercises at once. Rather, you should perform a group of exercises at a time, starting at the top of the list. You should concentrate on performing only the exercises that cause dizziness. When you can perform a particular section of exercises without feeling dizzy, you should proceed to the next group down the page.


A Sitting
1. Eye movements—at first slowly, then quickly:
• up and down
• from side to side
• focus on finger with arm extended and slowly move finger towards face until vision starts to blur.
2. Head movements—at first slowly, then quickly (later with eyes closed):
• bend forward and backward
• turn from side to side.
3. Bend forward and pick up objects from the ground.

B Standing
1. Follow steps 1 to 3 described above while standing.
2. Change from sitting to standing position with eyes open and shut.
3. Throw a small ball from hand to hand (above eye level).
4. Change from sitting to standing position and make a full turn in between.


C Moving about
1. Circle around a centre person who will throw a ball back and forth. 2. Walk across a room with eyes open and then closed.
3. Walk up and down a slope with eyes open and then closed.
4. Walk up and down steps with eyes open and then closed.
5. Any game involving bending, stretching and aiming such as tennis, bowls or basketball.


Avoid these situations for your safety.

Sudden rapid movements
In the dark
On soft or uneven ground (soft sand is okay if you have support and feel safe)
Influence of sedative drugs or alcohol


Other Tips

Make sure you do the exercises regularly
Build up your confidence by achieving improvements with the exercises.
Take a walking stick with you
Wear sensible shoes - flat soles with good grips,
Good vision helps balance.
Leave a night light on in the bedroom
Make sure you get sufficient rest


If you need further help please notify your doctor. You may be able to see a physio for further guidance. 

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