Welcome back to TGIF Dr EUAN's blog post!
We are delighted to have our Guest Writer: Ms SEAH WEI WEI share with us the benefits of Vestibular Rehabilitation (Balance Exercises). Ms Seah has a wealth of experience for more than 20 years at Tan Tock Seng Hospital and before leaving for Private Practice.
Q: Can I exercise if I am feeling dizzy and off-balanced?
When you are dizzy, exercise is probably the last thing on your mind. You may also be concerned with avoiding any movements or activities that may potentially trigger your dizziness or imbalance. However, once the initial phase of intense dizziness has passed, gradually incorporating physical activity and exercise into your daily routine can help you to feel less dizzy and help you gain confidence with your balance.
Q: What is Vestibular Rehabilitation? How does Vestibular Rehabilitation help with my dizziness and imbalance?
Vestibular rehabilitation uses a customised, exercise-based approach to reduce dizziness and imbalance symptoms linked to reduced function in the vestibular (inner ear balance) systems. Targeted exercises are prescribed according to each individual's specific symptoms to promote compensation and adaptation in the balance systems. These exercises aim to reduce vision disturbances and dizziness symptoms during movement and to improve balance and tolerance during daily activities.
Some of these exercises may include:
1.Gaze stabilization exercises:
Gaze stability is crucial for maintaining clear vision during head movements. These exercises are focused on enhancing head and eye movement coordination through adaptation of the vestibular-ocular reflex. Gaze stability exercises aim to mitigate symptoms like blurriness or difficulty focusing that can occur with some vestibular disorders.
2. Balance and Habitation Exercises:
These exercises are designed to improve overall balance and tolerance to movement, reducing the likelihood of falls and improving confidence during daily activities.
3. Compensation and Adaptation Exercises: These exercises aim to promote compensation and adaptation mechanisms within the vestibular deficits and enhance the ability to perform daily tasks and activities despite them.
4. Canalith repositioning Treatment:
Some patients may require additional treatment for Benign Paroxysmal Positional Vertigo (BPPV), a common disorder of the inner ear characterised by brief episodes of vertigo (spinning sensation) triggered by some changes in head positions. This is usually caused by displaced otoconia (tiny calcium carbonate crystals) within the vestibular system in the ear. BPPV is often treated using a sequence of head movements that aim to move the otoconia out of the sensitive areas of the inner ear canals when they cause symptoms.
Q: How are vestibular rehabilitation exercises prescribed?
Vestibular exercises are prescribed progressively, starting with basic movements and gradually increasing in complexity and difficulty as your symptoms and tolerance to movement improve. Throughout the rehabilitation process, progress is monitored closely, and exercises are adjusted as needed to ensure optimal improvement and adaptation.
Vestibular Rehabilitation aims to:
Relieve symptoms of dizziness
Improve balance function
Reduce risks of falls
Improve confidence in daily activities
Promote return to usual activities including sports and outdoor activities
Enhance the overall quality of life
It is usually supervised by a physical therapist specialising in vestibular disorders who tailors the program to the individual's specific needs and progress.
Q: Can general physical activity and exercise help with my dizziness and imbalance?
Incorporating exercise into your daily routine is a great way to support your recovery.
Physical activity can help improve balance by getting your muscles stronger, improving
flexibility and enhancing overall fitness, cardiovascular health and quality of health.
Regular physical activity can also help manage stress and reduce feelings of anxiety that can worsen dizziness and balance symptoms in individuals with vestibular
dysfunction.
Some exercises and physical activities may involve challenging your balance. Do be
mindful to do them in a safe environment, either on your own or as part of a group.
Try out some of these ways to keep physically active:
Walking: Especially outdoors in different environments and on different surfaces can help challenge the balance system and improve your ability to balance and move confidently in a variety of physical and visual environments.
Jogging, cycling or swimming: These activities promote cardiovascular fitness and support overall physical and visual environments.
Gentle weight training or Bodyweight exercises: Building core muscle strength and strengthening major muscles in your arms and legs can be helpful to improve overall balance and reduce the risk of falls.
Stretching exercises or Yoga: Exercises such as stretching and Yoga help to improve flexibility, which is crucial for mobility and balance. Depending on the type of yoga practised, Yoga can provide a gentle physical activity that promotes flexibility and strength without overly taxing the body. Yoga also emphasises the mind-body connection and can help to foster better body awareness and improve the ability to respond to changes in balance.
Dancing, martial arts & athletic drills: These activities can improve coordination and agility, which are important for balance and motor control.
Tai Chi: Involving smooth and controlled movements, Tai Chi is a gentle and effective way to enhance balance control and reduce fall incidence in older adults and individuals with balance dysfunction.
Tennis, volleyball, table tennis: These recreational sports involve head and eye coordination and can often be adapted to include exercises that challenge balance and coordination, which can be beneficial for patients recovering from vestibular dysfunction and are looking to return to these activities.
Q: I am keen to get more active, how do I find out more about
exercises classes near me?
In Singapore, HealthHub and ActiveSG Circle are great resources for information on
structured exercise classes in the community. Some programs cater to a range of ages,
interests and fitness levels, including exercise programs suitable for seniors.
Some tips on getting active:
Introduce any new activity slowly to allow time for your body to adapt gradually and for you to monitor your response to the activity.
A good guide is to start with 10 minutes of physical activity every day.
Gradually work towards accumulating 150 minutes of moderate-intensity exercise a week, as recommended by the Singapore Health Promotion Board.
Some practical ways to include more active time in your day is to include activities that you can do at home or while commuting, such as washing the car, doing vigorous housework, or climbing the stairs or brisk walking.
Do muscle and bone-joint strengthening activities at least twice a week.
Before starting a new exercise routine, check with your healthcare team or physiotherapist to ensure the activities are appropriate for your individual condition and recovery goals.
Well, I do hope this blog post has given you some useful information on Vestibular Rehabilitation. If you require a physiotherapist who specialises in vestibular management or if you would like to see an ENT about your dizziness, vertigo, or related issues, please reach out to Wei Wei at The Physio Movement at 6415 8790 and us at Euan's ENT Surgery & Clinic.
You can also contact us at 6694 4282 to schedule a consultation. We are here to help you take the first step towards better balance and improved well-being.
Have a good weekend!
Dr. Euan 😊
REFERENCES:
Kundakci B, Sultana A, Taylor AJ, Alshehri MA. The effectiveness of exercise-based vestibular
rehabilitation in adult patients with chronic dizziness: A systematic review. F1000Res. 2018 Mar
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2. Hall CD, Herdman SJ, Whitney SL, Anson ER, Carender WJ, Hoppes CW, Cass SP, Christy JB, Cohen
HS, Fife TD, Furman JM, Shepard NT, Clendaniel RA, Dishman JD, Goebel JA, Meldrum D, Ryan C,
Wallace RL, Woodward NJ. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An
Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the
American Physical Therapy Association. J Neurol Phys Ther. 2022 Apr 1;46(2):118-177.
3. Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L,
Hopewell S, Lamb SE. Exercise for preventing falls in older people living in the community. Cochrane
Database Syst Rev. 2019 Jan 31;1(1):CD012424. doi: 10.1002/14651858.CD012424.pub2. PMID:
30703272; PMCID: PMC6360922.
4. Health Promotion Board launches National Physical Activity Guidelines (hpb.gov.sg)
5. Active Health Programmes for Seniors (activesgcircle.gov.sg)
6. Great things start when you MOVE IT! (healthhub.sg)
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