Balance therapy exercises, also known as vestibular rehabilitation therapy, include classic Cawthorne-Cooksey standing and sitting exercises, alternative martial arts-based exercises, and individualized therapy, which occasionally relies on sports equipment and computers for virtual reality exercises. All three categories of balance therapy exercises use tilting and swaying to simulate conditions for dizziness and falling. At the same time, they require counter moves so that those with neuromuscular deficiencies can regain balance and relearn stability.
Cawthorne-Cooksey exercises were the original way that doctors handled balance problems for those suffering from vertigo or other losses of equilibrium due to injury, disease, or aging. These classic maneuvers are frequently divided into four categories: eye movements, sitting, standing, and motion exercises. They are frequently performed using standard household equipment such as a chair, a bed, and an even floor in a room without sharp edges or other hazards.
One Cawthorne-Cooksey eye exercise involves sitting on the edge of a bed while moving the eyes slowly up and down and then from one side to the other for 10 to 30 repetitions. The hardest Cawthorne-Cooksey balance therapy exercises are the motion exercises. They involve walking in circles or up and down stairs with eyes alternately opened and closed.
In the mid-1990s, audiologists and physical therapists began to develop more individualized therapy instead of using the Cawthorne-Cooksey moves for everyone diagnosed with balance deficiencies. These customized balance therapy exercises still included typical techniques such as gaze stabilization, but leveraged the use of props. For example, in one gazing exercise, patients might rotate their heads while trying to keep the eyes locked on objects held in front of them by therapists.
Individualized visual dependence exercises include moving about a familiar environment with the eyes veiled. Customized vestibular therapy also involves the use of tilt boards and outdoor sandy areas to test over-reliance on ankles for balance, a condition formally known as somatosensory dependence. Otholithic recalibration, which uses trampolines and Swiss balls, is an additional part of individualized balance therapy exercises and is used to improve coordination between ears and eyes. The ears are a major part of balance training, because balance is controlled by the vestibular system, which is located in the inner ear and is linked to the way fluid moves inside the ear.
Many patients elect alternative types of balance therapy exercises which involve the use of Eastern fitness moves known for promoting balance. Yoga and tai-chi are used by many patients to strengthen coordination and motion steadiness. Pilates is another alternative therapy used to regain the posture and proper body alignment necessary to balance while moving and standing. These alternative forms offer the additional benefit of increasing strength and flexibility so that injuries from falling are minimized. Gyrokinesis® is a final alternative therapy that involves fluid motion exercises to fight balance disorders.