To VRT or not to VRT?

You’re welcome. There are lots of copies of the Cawthorne-Cooksey exercises online. They are all basically the same thing but I prefer the Brain and Spine uk version. I’m not allowed to put links in my posts but let’s try this:

The domain is brainandspine. Put www in front of it and dot org dot uk after it. Then go to the publications page and select fact sheets. You should find vestibular rehabilitation towards the bottom of the list.

Re swimming, I enjoy it too! I went yesterday and, I have to say, it really screwed my head up! But I think that’s the point. The idea is to exercise the vestibular system and it certainly does that. I think if you do decide to start again maybe take it easy to begin with? I probably overdid it yesterday. Have only been 3 times since lockdown eased and I swam for 30 minutes. Probably not fully used to it yet.

Re the list of Optokinetic exercises, I’m working on it but I suspect the administrators might move it somewhere else as they have done with the following.

@TexOkie. As you can see, my reply to your query about “supermarket syndrome” has been moved! I hope you’ve seen it. If not I can message you with the info.

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Here is the one referred to above. These were the original VRT exercises from way back. 1940’s if not earlier.

@Onandon03. Many thanks for putting the link in. Both @Katharina and @Belindy have asked for links to optokinetic exercises. Please could you advise the best way of doing this given that I’m not allowed to put links in posts or messages?


PM me with how to locate them and I will load them. No probs

Thank you @Dizzi-Tired and @Onandon03. The exercises look very straightforward and I’ll give them a try. I also usually swim for 30 minutes, but I’ll take up your advice and try for less once it is warmer here.

A friend of mine came up with the idea of getting some juggling balls and learning how to juggle. And I saw an interesting video on playing table tennis by myself. Here is a link: Practicing Alone in Table Tennis | PingSkills - YouTube

I think both the juggling and the table tennis practice will also help with my rehab. I’ll let you know whether they do.

I’d recommend that you follow your neurologists suggestion and leave VRT alone until such time as she feels it’s appropriate. Certainly try table tennis and walking outside which is in itself excellent VRT or any other natural movement type exercise (Tai Chi is basically walking) or even look out for balance exercises, the U.K. NHS website has loads rather than going against the neurologist’ s recommendation and attempting DIY VRT either Cawthorne-Cooksey or off the internet. Unsupervised exercises most particularly eye exercises can most definitely make balance issues worse. Juggling might be an option for some. From my own VM experience I’d say if anybody with VM can effectively juggle then I’d doubt they need any VRT anyway. They really cannot have much wrong with either vision or coordination.

Beginner Exercises for Balance and Toning

Love that idea! Very good for symptom distraction too!

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I can’t imagine even trying to juggle. Before all this started, I tried to learn, and I couldn’t even learn to keep two balls in the air, much less three or more. It was horribly frustrating.

But then I’ve been a clutch all of my life. Perhaps the VM was working on me way back then?

Me too @turnitaround. It was so unexpected and I had not read about it anywhere. After breakfast today, I am going out to buy table tennis bats, balls and juggling balls as well.

Add ‘jigsaw puzzles’ to that shopping list. They are excellent VRT.
Jigsaw puzzles

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I have a few jigsaw puzzles at home and I love doing them. However, I find that it is difficult to keep a good posture when I am doing them. My neck gets quite stiff (and it is already stiff), so I can only do them for very short periods of time.

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As of Thursday, I have completed two VRT sessions and done the exercises on my own once. I’ve never had a period as long as I’m currently having where my symptoms were so bad. It’s as if the VRT is exacerbating the symptoms and about the time they settle back down, it’s time for another session. I’m not sure I can take this for six weeks, especially on the off chance that it might work.

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VRT is a long process. It’s not a quick fix and it takes weeks to months to begin to see a difference. You should only be ‘just’ triggering dizziness in your exercises or you are going too far.

You should also be pretty stable/at baseline before you start. Definitely not mid attack.

Take it slowly.


I was very interested to see the table tennis idea, as I do play twice a week (when not in lockdown). It is very challenging (I am in a constant state of disequilibrium) but there is no doubt that I am getting better all the time. It’s a slow process as it’s been two years now and I certainly couldn’t play for the initial six months after my problems started. I haven’t gone back to playing singles competition as that is too intense - long rallies with repetitive strokes and turning the body make me too dizzy. It really is a fine line- need to constantly challenge ourselves but not overdo it.


That is fantastic! When my neurologist suggested it, I was keen to join a table tennis club immediately and get some coaching lessons, but I don’t think I would have been able to last for more than five minutes. Instead I bought a table tennis bat and practice by myself twice a day for 5-10 minutes. It is challenging for my eyes, but I can feel that it is good for me. It is great to hear that you are playing twice a week. It gives me hope that I can do it as well in the future.

VRT session three is this morning. I’m not sure I have the courage to tell the therapist that I didn’t do any exercises this week. My grandkids are visiting for the week, and I’m trying not to have an attack while they are here.

I’ve also got a headache coming on this morning. I’m not sure if it’s the run of the mill variety or a form of migraine.

What’s that old saying? When you’re a hammer, everything starts to look like a nail? I suspect that when yore a MAV’er, everything starts to look like a migraine.


Apparently, I had a small flareup today. It only lasted about 5 hours and seems to have dispersed. I am now only mildly dizzy, which is becoming normal for me.

I have been playing with my new juggling balls and the table tennis bat for a few days now. I find that I am ok while I am playing with them (the juggling balls are falling to the floor most of the time), but I can feel afterwards that my balance is off for a while. I am not sure whether this is a good or a bad sign?

If no migraine, I’d say fine.

VRT/activity is only bad if it precipitates a full on migraine.

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Or a full on vestibular attack.

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