Persistent Symptoms - Maladaption? - PPPD?

Now, long time on meds, my symptoms have reduced considerably and what is left (mainly intermittent Postural Unsteadiness) seems to be pointing me more and more in the direction of my MAV having morphed more towards being some form of PPPD. Reading some recent articles on the subject I find this more and more and wonder how it has come to occur.

A few days back I came across this brief article which resonated with me so much.

I quote:

“Persistent symptoms of dizziness may be due to inappropriate compensatory strategies following an episode of acute dizziness. Common symptoms are dizziness in an upright position that is aggravated by visual stimuli and passive movement”

”The normal reaction to acute dizziness is to activate motion control strategies by leaning on something for support or by using the eyes to focus on fixed points”

”if the patient continues to lean on objects for support or to use their eyes to focus on fixed points while in motion, this may prevent recalibration of the balance system and trigger a vicious cycle with cautious and stiff gait, myalgia, anxiety and avoidance behaviours.”

A few weeks back I tried a set of balance exercises I’d found on the internet and was surprised to discover although I could stand steadily on one leg, either leg with eyes open, I’d really wobble once I tried it whilst moving my head side to side and subsequently read eye fixation is as good as having an extra leg on the ground with balance issues. Something I knew really but hadn’t obviously properly appreciated previously.

With me I’ve found the ‘eyes in fixed points’ may well be instrumental in prolonging some of my remaining symptoms. I remember very early on being told by VRT to work outside every day and to facilitate that by picking a point straight ahead and walking towards because it would help me balance which it did and which I much needed at the time and have continued to use and need virtually ever since. Many times I’ve tried to reduce my dependence on this strategy, and stumbled or veered abruptly off to the right, always the right though I’ve kept trying mostly unsuccessfully. A compounding factor in my case may be the fact that I tend normally to walk paths, cycle paths or paths on circular walks where the natural tendency is to look more or less straight ahead, rather than over open areas. This last month or so however I’ve had more access to open space, huge fields covered in stubble and I have quite coincidentally been pushing myself to look around much more and it’s working. Not only can I look around more comfortably whilst maintaining a straight line but I am beginning to experience other improvements. I’m beginning to lose the stiff postural rigidness that comes with constant unsteadiness. I noticed yesterday I tilted my head back in the shower and wiggled cat-like under the spray to rinse soap off my back which I hadn’t done for years. I’ve also regained my normal walk and most of my previous speed out walking too this same week. No doubt the rough even stubble under foot - natural VRT - has helped too. I’m just hoping not to revert once the stubble becomes plough and I once more lose access to the open fields.

Having experienced some success now I’m beginning to wonder what other type of ‘home-made’ VRT might help. Helen