The balance exercises were first suggested by Sir Terence Cawthorne and F S Cooksey over half a century ago for people who had undergone surgery which. Cawthorne-Cooksey Exercises. SUPPORTING If your vestibular system (inner ear balance system) is not working properly, you will feel dizzy and off balance. Cawthorne-Cooksey Exercises. The aims of the Cawthorne-Cooksey exercises include relaxing the neck and shoulder muscles, training the eyes to move.

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Cawthorne-Cooksey Exercises for Dizziness

Vestibular compensation in a patient with a cerebellar infarction. Make sure that you are in a safe environment before you start any of the exercises to reduce the risk of injury. Recovery is delayed if visuomotor experience is prevented during the early stage after cookssy vestibular loss.

Postural stability recovery is slower than gaze stability recovery.

Vestibular rehabilitation exercises

Here the authors review the mechanisms and the key exercises for each of the VRT goals. However, a relapse may go undetected in those with a persistent and complete unilateral vestibular deficit. These patients should be retrained to use the redundancy within the balance system. Assessing the influence of sensory interaction of balance. Abnormal postural strategies in vestibular dysfunction Patients with vestibular loss use the ankle strategy but not the hip strategy, even when the hip strategy is required for postural stability, such as when standing on one foot, across a narrow beam, or in a heel-toe stance.


This approach is also used when the exercises stimulate prolonged periods of aggravated vertigo following the exercise activity, thereby disrupting daily routines. Exercises for enhancing eye movements are shown in Fig.

You may feel dizzy for the first 48 hours after the treatment.

However, if vestibular function does not recover, dynamic signs will persist for life, leading to blurred vision and imbalance when patients turn their head toward the side of the affected labyrinth. Otolaryngol Head Neck Surg.

To overcome this, patients should practice performing tasks while sitting or standing on surfaces with disrupted somatosensory cues for orientation, such as carpets, compliant foam, and moving surfaces e.

Short-term vestibulo-ocular reflex adaptation in humans. These eye movements are not vestibular in origin, but result from central preprogramming and efferent copy of the motor command. It is unclear exactly how these exercises work. The aim of gaze stabilisation exercises is to improve vision and the ability to focus on a stationary object while the head is moving.

Exerfises are several ways to increase the effectiveness of vestibular adaptation during head movements. Patients with panic disorder and other anxiety disorders often seek treatment for ill-defined vestibular symptoms. In older adults with symptoms of dizziness and no documented vestibular deficits, the addition of vestibular-specific gaze stability exercises to standard balance rehabilitation results in a greater reduction in fall risk.

While good visual inputs are recommended, eye glasses can aggravate vertigo during head oscillation. Essentially, the brain copes with the disorientating signals coming from the inner ears by learning to rely more on alternative signals coming from the eyes, ankles, legs and neck to maintain balance. The authors have no financial conflicts of interest. Cawthornf ankle strategy can be practiced by swaying back and forth and side to side within small ranges, keeping the body straight and not bending at the hips or knees.


This article has been cited by other articles in PMC.

Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

J Am Geriatr Soc. Thus, the use of a cane, which acts as an extended haptic ‘finger’ for orientation to an earth reference, is an important tool for postural rehabilitation.

Benign paroxysmal positional vertigo in the elderly. Training that involves progressively increasing retinal slip errors is more effective than the use of sudden, large errors. Advances in the treatment of vestibular disorders. VRT is applicable to patients with stable vestibular lesions whose vestibular function is poorly compensated, regardless of their age, the cause of their lesion, and symptom duration and intensity.

However, the mean duration of therapy required to achieve the eventual outcome is significantly longer in patients using medication. Physical therapy assessment of vestibular hypofunction.