The balance exercises were first suggested by Sir Terence Cawthorne and F S Cooksey over half a century ago for people who had undergone surgery which. Cawthorne-Cooksey Exercises. SUPPORTING If your vestibular system (inner ear balance system) is not working properly, you will feel dizzy and off balance. Cawthorne-Cooksey Exercises. The aims of the Cawthorne-Cooksey exercises include relaxing the neck and shoulder muscles, training the eyes to move.

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Brain & Spine Foundation | Vestibular rehabilitation exercises

Some of these exercises will not be suitable for everyone, and some are only suitable for certain conditions. It can be helpful if someone else learns the exercises and helps you with them. Sitting Eye movements and head movements as above Shoulder shrugging and circling Bending forward and picking up objects from the ground Standing Eye, head and shoulder movements as before Changing from sitting to standing position with eyes open and shut Throwing a small ball from hand to hand above eye level Throwing a ball from hand to hand under knee Changing from sitting to standing and turning around in between Moving about in class Circle around center person who cawfhorne throw a large ball and to whom it will be returned Walk across room with eyes open and then closed Walk up and down slope with eyes open and then closed Walk up and down steps with eyes open and then closed Any game involving stooping and stretching and aiming such as bowling and basketball Diligence and perseverance are required but the earlier and more regularly the exercise regimen is carried out, the faster and more complete will be the return to normal activity.

Your GP can refer you. These exercises are likely to make you feel dizzy whilst you perform them, but it is important to persevere in order to feel any benefit. Individual patients should be accompanied by a friend or relative who also learns the exercises. Canalith repositioning procedures involve a sequence of specific head and upper body movements that may be able cooksy move the crystals back to their correct place in the ear.


The CC exercises are cawthornr used as a home program This document is one page handout of activities that progress from simple head movement to complex activities such as throwing a ball. Spanish translation of CC exercises courtesy of Maria Busso. The CC exercises are mainly used as a home program.

For example, 0 through to 5 for the severity of your symptoms 0 being no symptoms and 5 being severe symptoms. The aim of gaze stabilisation exercises is to improve vision and the ability to focus on a stationary object while the head is moving.

Adapted from Dix and Hood, and Herdman, ; References: You might be interested in reading our Dizziness and balance problems booklet for further information on the different causes of dizziness and the conditions that can be treated with vestibular rehabilitation exercises. These exercises may also be advised if CRPs are not suitable. This fact sheet provides information on vestibular rehabilitation exercises for people with dizziness and balance problems.

It is thought that BPPV may be caused by crystals also known as otoconia becoming dislodged from their normal place inside the inner ear, and moving into another area within the ear that is responsible for sensing rotation the semicircular canals.

One of the first “general” interventions for vestibular problems were the Cawthorne-Cooksey CC exercises, as shown below.

The CC exercises are still in common use see numerous references at bottom of this document. They should be completed slowly at first.

Cawthorne Cooksey Exercises In bed or sitting Eye movements exeecises at first slow, then quick up and down from side to side focusing on finger moving from 3 feet to 1 foot away from face Head movements at first slow, then quick, later with eyes closed bending forward and backward turning from side to side.

Call Essentially, the brain copes with the disorientating signals coming from the inner ears by cawyhorne to rely more on alternative signals coming from the eyes, ankles, legs and neck to maintain balance. Although some authors state that the CC exercises are outmoded, this is not true.

Please note that you should not attempt any of these exercises without first seeing a specialist or physiotherapist for a comprehensive assessment, advice and guidance.


In particular, the manoeuvres will not be suitable if you have pain or stiffness in your neck or if you have had a neck injury.

Vestibular rehabilitation exercises

If the treatment has worked successfully for you, your symptoms should improve within a couple of weeks. As the exercise becomes easier over time you can start to do them more quickly. One can find the original document illustrating the CC exercises here.

Please be aware that it may take a few days for you to get used to the exercises. It may be advised not to undertake exercises that you would rate a 4 or 5 on the scale.

Alternatively, it may be that repeated exposure to movements that provoke dizziness symptoms teaches your brain not to listen to the signals it is receiving from the ears as much vestibular compensation. It would be advisable to start each exercise at a level that you would rate as a 2 or 3 on the rating scale i.

A diary such as the one below might help you to keep track of the exercises and help with knowing when to make each one harder. Ideally these activities should be done with a supervised group.

You might find that your dizziness problems get worse for a few days after you start the exercises, exeercises you should persevere with them.

The repeated head movements may work by moving the crystals back to their correct position inside the inner ear as with CRPs. You could ask if it is possible for a friend or relative to be with you at the assessment.

If your dizziness persists or comes back, it might be possible to have the treatment again. You will be given guidance on how many repetitions of each exercise to do and when to cookseey to the next set of exercises. All responses are completely confidential so no individual answers will be identifiable to any person.

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