While improving mobility and balance is the primary goal of vestibular rehabilitation, it can also 

have a positive impact on an individual's quality of life

Vestibular adaptation and vestibular replacement are the techniques via which vestibular 

deficits heal. The vestibular adaptation method is comparable to the one Cawthorne outlined 

for those who have ongoing disequilibrium. Vestibular adaptation refers to modifying the 

vestibulospinal reflex (VOR) gain, while vestibular compensation refers to alternate methods 

of substituting for decreased vestibular function.

VRT aims to improve vertigo, improve ocular stability, improve postural stability, and improve 

daily living activities.

Physical treatment for vestibular hypofunction and canalith repositioning therapy for benign 

paroxysmal positional vertigo (BPPV) are the two categories into which the exercises for 

vestibular rehabilitation fall.

Cooksey-Cawthorne Exercises

The Cawthorne-Cooksey exercises aim to improve overall coordination and movement, teach 

the eyes to move independently of the head, relax the muscles in the neck and shoulders, and 

practice head movements that create dizziness in order to aid vestibular compensation.

To make sure you are performing the right activities, you should be evaluated for a 

personalized fitness program. To lower your risk of injury, make sure you are performing any 

of the activities in a safe area. If you feel like you could fall and there aren't any safety 

precautions in place to stop it, don't do any activities.

The following exercises could be part of them :

A. While seated or lying down

1. Head motions

a. Changing direction from side to side; bending both forward and backward

2. Eye motions

a. Pay attention to the finger going from three to one foot away from the face 

while it moves up and down and side to side.

b. Seated Head and eye motions as described above Shoulders shrugged and 

circled Bending from side to side, get items from the floor. Lean forward and 

retrieve items from the floor.

c. In a standing position Movements of the eyes, head, and shoulders, like in 1 

and 2.Go from a sitting to a standing posture, opening your eyes first, then 

closing them. Toss a ball above your head from hand to hand. Toss a ball 

beneath the knee from hand to hand. Shift from a seated to a standing posture, 

then pivot

d. Relocating

i. Climb and descend a hill

ii. Climb and descend stairs

iii. Toss and retrieve a ball

iv. Any game that requires you to aim, bend, and stretch (like bowling).

Canalith Repositioning (CRPs)

The purpose of canalith repositioning procedures (CRPs) is to treat persons with 

benign paroxysmal positional vertigo (BPPV). BPPV can occur when dizziness is 

brought on by the passage of otoconia, or calcium carbonate particles, from the utricle 

into the semicircular canals of the inner ear. With a few precise head and neck motions, 

canalith repositioning techniques assist in moving the crystals back to their proper 

location within the ear.

The Epley maneuver and the Semont (Semont-Liberatory) maneuver are the two 

primary CRP therapies. It is crucial that these maneuvers are exclusively carried out 

by a qualified professional in order to reduce the possibility of back and neck trauma.

The Epley maneuver should be used if the right ear is sick.

• To begin with, take a seat on a bed.

• Rotate your head to the right by 45 degrees.

• Quickly recline with your head turned back. Now place your shoulders on the pillow 

and lay your head back. Hold on for 30 seconds.

• Without lifting it, turn your head 90 degrees to the left. At this point, your head 

should be angled 45 degrees to the left. Give it another 30 seconds.

• Take a further 90-degree turn to the left with your head and torso to enter the bed. 

Give it another 30 seconds.

• Take a left-hand seat upright.

For a left ear ailment, the recommended course of action is to: • Sit on a bed; • Rotate 

your head 45 degrees to the left.

• Quickly recline with your head turned back. Now place your shoulders on the pillow 

and lay your head back. Hold on for 30 seconds.

• Without lifting it, turn your head 90 degrees to the right. At this point, your head 

should be angled 45 degrees to the right. Give it another 30 seconds.

• Take a further 90-degree turn to the right with your head and torso to enter the bed. 

Give it another 30 seconds.

• Take a right-side seat.

The Brandt-Daroff exercise

Engaging in Brandt-Daroff exercises is a superior way to control BPPV that do not 

react to CRPs. Exercises for Brandt-Daroff can be done at home even without a 

professional's supervision.

▪ While perched on a bed's edge, tilt your head 45 degrees to one side.

▪ Immediately lie down on the other side, so that the back of your head meets 

the bed (to the left if you turned your head to the right, and vice versa).

▪ Remain in this posture for approximately 30 seconds, or until the 

lightheadedness subsides.

▪ Go back to your seated position.

▪ On the opposite side, repeat steps 1-4.

Once you have done six repetitions on each side, you should repeat these 

instructions three more times

If advised otherwise by your physiotherapist or expert, you should perform the 

exercises two to three times a day for a period of two weeks.

You will have vertigo when performing these exercises, but it is crucial to do 

them in order to experience any benefits.

Ascent ENT Hospital in India offers state-of-the-art facilities and expert care for ear, nose, and throat conditions, ensuring patients receive comprehensive treatment and personalized attention.