When the human body is in different positions and different environments, the visual, proprioceptive and vestibular receptors of the inner ear receive information and transmit it to the cerebellum, which causes the cerebellum to issue balance instructions, move joint muscles, change positions and maintain balance. Among the balance triad, the vestibular system in particular is the most important for the body’s balance control. When there is a lesion in one side of the vestibule, the original balance of the body is disrupted and sensations such as vertigo and spinning occur.
Vestibular rehabilitation due to vestibular lesions resulting in a state of disequilibrium, after rest and treatment, vertigo and other sensations can be relieved, most of which are the result of reestablishing balance after the nerve center has been adjusted to produce vestibular compensation. The plasticity and compensatory capacity of the vestibular system has been widely recognized as the main basis for rehabilitation training. Vestibular rehabilitation looks at improving the gain of residual vestibular function and promotes the use of alternative mechanisms or strategies to achieve vestibular compensation.
Vestibular rehabilitation exercises Vestibular rehabilitation exercises can enhance the patient’s balance and improve his or her tolerance to vertigo, and their effectiveness and reliability are being confirmed by a growing number of clinical studies. Vestibular rehabilitation training is gradually showing its wide application prospects and becoming another important means of treating vertigo diseases in addition to drugs and surgery. Personalized training can propose a targeted training program according to the patient’s diagnosis or functional deficiency, and regularly evaluate the condition during the treatment process and make corresponding adjustments and modifications at any time.
Personalized training methods mainly include.
1. Adaptive exercises can improve vestibulo-ocular reflex gain, which is closely related to the improvement of patients’ subjective symptoms.
The method places the object 25 cm in front of the nose, turns the head while gazing at the object, tries to keep the visual clarity, gradually increases the speed of turning the head, repeats 15-20 times, and repeats 2-3 times a day.
2. Alternative exercises can increase gaze stability and control of posture and gait, including visual stimulation exercises and proprioceptive exercises. Based on the fact that altering or removing certain sensations will prompt the patient to utilize the remaining sensations, methods such as
Methods allow patients to practice with or without a visual perspective or have them stand on foam material to alter proprioception for practice.
3, habituation exercises can promote the occurrence of vestibular habituation, choose exercises that stimulate symptoms, the intensity of the exercise should be to elicit mild or moderate symptoms, train for 5-15 minutes, and repeat 2-3 times a day. If the symptoms do not improve or the vertigo disappears after a certain period of time, stop this exercise.
Depending on the symptoms, there are many methods of practice, such as Brandt-Daroff practice exercises.
(1) Method Patients quickly lie down to the affected side, hold for 30 seconds after the vertigo disappears, then sit up and wait for the vertigo to disappear; patients repeat the above exercise to the opposite side, stay for 30 seconds and sit up. Repeat 10-20 times, 2-3 times a day, if no vertigo appears in 2 days, treatment can be stopped.
(2) Balance and gait exercises to improve static and dynamic postural control as well as walking, including static exercises and dynamic exercises to identify postural instability. Train for 5-15 minutes daily and repeat 3 times a day, gradually increasing the difficulty.
The method can allow the patient to go from sitting to standing with eyes open and closed, adapt and turn around.
4. Maintenance exercises can stabilize and consolidate the effect of rehabilitation training, including balance and gait exercises of mild and moderate difficulty, as well as visual and proprioceptive substitution exercises.
Rehabilitation exercise principles have been verified through many clinics that rehabilitation training helps to rehabilitate the function of the vestibular system. In order to improve the rehabilitation effect, the following principles need to be followed during the training process.
1. Know what may happen to the patient during training and eliminate the patient’s fear.
2.Treatment should be early and early intervention is very important to improve the quality of rehabilitation.
3.The initial exercise can be brief and the patient is encouraged to perform head movements.
4.After completing the initial vestibular function training, more complex exercises can be performed.
5. Limiting exercise, reducing visual signal input and vestibular suppression medications can delay the onset of recovery and limit the ultimate level of recovery.
It is believed that following certain principles and using different rehabilitation training methods such as the above to improve the patient’s stability and sense of imbalance as much as possible will allow the patient to return to a normal life.