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Exercises for ­ people with impaired balance may be divided into two types: exercises intended to improve gait and balance for every­ one, regardless of the prob­ lem, and exercises specifically designed to retrain how the ear and brain work together. The two general goals of a balance exercise program are, first, improving mobility and, second, preventing falls. A balance exercise program should include exercises focused on: • Ability to control your body position and distribution of weight in space, sometimes described as your center of mass. • Strength, particularly in the thighs and legs, so that if you do lose your balance, you ­ will have more power to recover. • Range of motion of joints, including the shoulders, hips, knees, and ankles. • Cardiovascular function. To improve strength, practice standing up from a chair. If you have access to a gym, supervised pool, or community center that has balance or strength-­ training classes, consider taking advantage of­ these valuable resources. Exercises that address all of the above goals can be found on the National Institutes of Health (NIH) website. Search within the web Appendix Home Exercises Appendix: Home Exercises 170 pages associated within the vari­ ous institutes of the NIH, using as a search term any of the disorders discussed in this book. For example, an excellent site called Go4Life from the National Institute on Aging includes useful videos and explains and describes exercises addressing the four areas of focus listed above (https://­go4life​.­nia​.­nih​.­gov​ /­exercises).­ People who have suffered a loss of vestibular function in the ear or vestibular nerve have specific needs. The brain needs to be challenged to analyze motion even though it is receiving faulty information from one ear. This is accomplished in medical practice with some variation of vestibular exercises that include • ​Tracking visual targets with head still, then with head moving. • ​Rapid head movements when sitting, then walking. • ​ Walking in the dark and on uneven surfaces. Instructions for performing vestibular exercises can be found at www​ .­dizziness​-­and​-­balance​.­com​/­treatment​/­rehab​/­cawthorne​.­html. We are often asked how long ­ after an inner ear injury a person must continue exercises. We find that ­ people usually know when it is all right for them to discontinue ­ these exercises. If you stop ­ doing home exercises too soon—­ that is, before your brain has compensated fully for your inner ear prob­ lem—­ you may note a recurrence of dizziness or imbalance that once again improves when you resume exercises. The typical reasonable range of duration for an exercise program ­ after an episode of vestibular neuritis or labyrinthitis is weeks to months. For ­ people who have not been diagnosed with a loss of vestibular function, it is still beneficial to do exercises aimed at improving balance, strength, range of motion, and cardiovascular fitness. Walking on uneven ground, such as grass, dirt, or sand, is an excellent challenge for balance. If it can be done safely—­ without a significant risk of falling—­ walking on uneven ground usually helps­ people improve their balance. Tai chi and qigong are ancient arts that train balance. Classes are available in many communities, and Appendix: Home Exercises 171 videos may be found on the web. Many community centers, se­ nior centers, and recreation centers also host ­ free or inexpensive balance classes led by local physical therapists. If you are having difficulty walking, or can only walk a short distance before getting tired, it may be beneficial to see a neurologist who can analyze your walking difficulty and potentially identify specific abnormalities. For walking to occur normally, a symphony of movements must happen just right. If anything is off just a ­ little, the person may become exhausted when walking some distance and may have an increased risk of falls. For example, if your foot ­ doesn’t clear the floor easily, or if your muscles ­ aren’t strong enough to pick your thigh up at the hip, you may be expending an unnecessary amount of energy with each step. Many physical therapists are ­ adept at figuring out what exactly is not working well functionally, though they often appreciate some input from a neurologist to help guide design of an individualized treatment plan. If you see a physical therapist, work with him or her to start an individualized home exercise plan as early as pos­ si­ ble in the course of your treatment. This page intentionally left blank ...


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Related ISBN
MARC Record
Launched on MUSE
Open Access
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