Vol. 94 No.2 February 2001
Equilibrium Training
Yatsuji Ito (Gifu University)
Dizziness and disequilibrium are common symptoms of patients with vestibular disorders. These symptoms can persist for a long time in some patients, despite medication, and the patient's activities of daily living (ADL) can be restricted. Equilibrium training is used to reduce the disability of such patients.
In 1945 Cawthorne and Cooksey first described a system of rehabilitation for patients with vestibular injury, and many methods of training have been developed. In 1990 the board of the Japan Society for Equilibrium Research presented a standard of equilibrium training for patients with disequilibrium. In this paper, the concept of equilibrium training and the author's experiences with equilibrium training in patients with vestibular disorders are presented.
In our training program the degree of impairment, disability and handicaps of the patients were evaluated before training started. To evaluate subjective and objective disabilities, the ADL was investigated using a questionnaire and equilibrium function tests were performed. A level of difficulty was selected in order to challenge patients, and the patients performed those exercises three times a day at home. Training was continued until the patient's disabilities were reduced. The effects of training were assessed according to ADL, equilibrium function tests, stabilometry and gait tests.
We found many differences in disability among patients with similar impairments, and were able to plan an individual training program suitable for each patients. ADL and equilibrium function tests were useful for evaluating disability and the effect of training. Equilibrium training was effective even for older patients with bilateral vestibular disorders who showed chronic disability persisting for more than several weeks after onset.