Positional Vertigo Exercises

Before knowing about the basic positional vertigo exercises, let's have a brief idea of what exactly is benign paroxysmal positional vertigo (BPPV) and its symptoms.

What is Benign Paroxysmal Positional Vertigo (BPPV)?
Benign paroxysmal positional vertigo (BPPV) is an abnormal feeling of motion or spinning that may last for a few seconds or up to a minute. It occurs due to some problem in the inner ear, causing brief vertigo spells that come and go. The inner ear canal consists of tiny calcium stones coming from a structure in the ear called the utricle, which helps you to keep balance. These particles move around in the ear canal when we move in a certain way, like while standing up, looking up at a high shelf or at the sky, or turning your head. Due to some infection or inflammation, these stones are unable to move, as a result wrong signals are sent to the brain that affect our balance. You may experience a feeling of spinning or tilting while moving your head, rolling over in bed, turning your head quickly, bending over, or tipping your head back. Though it's not a serious health illness, dizziness, nausea and even vomiting are some common symptoms of vertigo. It usually lasts for a minute or two and can be mild or bad enough that sometimes you'll find difficult to stand or walk without losing your balance. Read more on:

• Vertigo Causes and Cures
• Causes of Vertigo

Benign Positional Vertigo Exercises
Benign paroxysmal positional vertigo exercises help the particles or stones in the semicircular canals of our ear to move freely. These positional vertigo exercises help in maintaining our body balance and prevent the vertigo from occurring.

Epley Maneuver
Also called the particle repositioning or canalith repositioning maneuver, it's a training exercise in which you have to position your head into four sequential movements by assigning a fixed duration of time for each position. The steps involved are:

• Sit upright and position your head to the symptomatic side at an angle of 45 degrees, and lie down on your back.
• Remain in this position for at least 5 minutes and then turn your head at an angle of 90 degrees to the other side.
• Remain in this position for another 5 minutes and turn your body onto your side with your face pointing downwards.
• After being in this position for 5 minutes, go back to your sitting position and remain in that position for nearly 30 seconds.
• Repeat the steps for at least 2 - 3 times and relax.

Semont Maneuver
Also called liberatory maneuver, this exercise involves swift movement of the head from one side to the other. The session lasts for 10 - 15 minutes, in which the head is moved firmly in different positions so that the calcium stones move freely and no longer cause vertigo symptoms. The steps to be followed are:

• Sit straight and turn your head at an angle of 45 degrees horizontally towards the unaffected ear.
• Tilt you head at an angle of 105 degrees so that you are lying on the side of the affected ear with your head hanging and facing upwards. Remain in this position for around 3 - 5 minutes, allowing the debris to move to the apex of the ear canal.
• Keeping your head in the same position, lie on the side of the unaffected ear with your nose pointed to the ground. Remain in this position for 3 - 5 minutes, allowing the debris to move towards the exit of the ear canal.
• Finally move back to your initial sitting position and relax.

Brandt-Daroff Exercise
This exercise is usually tried when the semont or modified epley maneuvers are not effective enough. In this exercise, the patient is repeatedly asked to shift from a sitting position to a lying position until the vertigo stops. It improves the brain's ability to cope up with the conflicting balance signals it is receiving.

• Sit straight on the edge of the bed and turn your head slightly to the left side at an angle of 45 degrees.
• Lie down quickly on your back to the right side and remain in this position for 20 - 30 seconds or until the dizziness resolves.
• Sit up straight and again wait in this position for 20 - 30 seconds or until the dizziness resolves.
• Now turn your head slightly to right side and lie down quickly on your back to the left side.
• Remain in this position for another 20 - 30 seconds and then sit upright, and repeat the procedure.

Read more on treatment of vertigo.

As a beginner, perform these positional vertigo exercises under doctor's supervision, and once you are thorough with them, try practicing them at home, at least 2 - 3 times daily. If you observe positive results after the first week of exercises, decrease the frequency to 3 - 4 times per week.