More MS news articles for August 2000

Rehabilitation of Vertigo

The balance parts of the two ears complement each other, sending equal impulses to the brain which are essential for the maintenance of equilibrium of the head and body.  If either or both balance centres are damaged, equilibrium is upset.  The result of this is vertigo or giddiness which may be accompanied by nausea and vomiting.

The purpose of the exercises is to build up a tolerance mechanism in the brain which compensates for the unequal balance of the two ears. The exercises stimulate the development of this tolerance mechanism and the more diligently and regularly they are performed the sooner will vertigo disappear.

The exercises should be carried out persistently for at least 5 minutes, three times daily, for as long as vertigo persists.  A conscious effort should be made to seek out the head positions and movements that cause vertigo in so far as they can be tolerated, because the more frequently vertigo is induced the more quickly is the brain compensation mechanism built up.


The Cawthorne/Cooksey system of exercises is designed to restore balance and to train the eye and muscle and joint sense by performing many exercises with the eyes closed.  The movements are carried out in the following graduated stages:

Stage 1:  Head kept still - in bed or sitting.  Eye movements only are practised looking up and down and from side to side and then focussing.  Focus on a finger held 3 feet away and follow the finger to 1 foot from the eyes.

Stage 2:  Head and eye movements while sitting.  Head movements bending forwards and backwards and then from side to side, at first slowly and then quickly. Repeat the movements with eyes closed.

Stage 3:  Head and body movements while still sitting. Movements of shoulder shrugging and circling are first practised.  Then pick up an object from the ground and look right up with it.  Bend forwards and then pass an object from hand to hand under the knees.  Relax in between the various movements.

Stage 4:  Standing exercises.  Carry out the following maneouvres in turn:

1.  Walk across room and around a chair with eyes open.  Repeat with eyes closed.

2.  Circle around a person who throws you a large ball and to whom you return the ball.

3.  Stand back-to-back with someone who passes you a large ball between the legs.  Pass the ball back above your heads.  Perform as quickly as possible.

4.  Walk up and down a slope with eyes open and later, closed.

5.  Walk up and down steps with eyes open and later, closed.

6.  Games involving stooping, stretching and aiming, e.g. bowls, skittles, or basketball.