VestibularActive referenceUnder clinical review

Vestibular Adaptation

Gaze-stabilisation + Cawthorne-Cooksey progression for vestibular hypofunction. Nausea/dizziness gating built in.

Condition: Vestibular Hypofunction · ICD-10 H81

Minutes / session

Weeks

Phases

Outcome measures

Under clinical review

At least one module, condition, or outcome record is not marked approved. Treat this page as educational reference material, not an individualized prescription.

Safety rules and escalation

Review these module-specific checks before considering any exercise phase.

Non-bypassable platform pain rules

Pain at or above 6/10 requires an exercise substitution.
Pain at or above 8/10 stops the workout and surfaces emergency-stop guidance.

Red-flag screening

Do you have new double vision, numbness, slurred speech, or severe headache?
Emergency Care · Stop and call emergency services; central vertigo requires urgent assessment.
Are you vomiting uncontrollably or unable to keep fluids down?
Urgent Care · Please see a clinician for hydration + symptom control.

Clearance and monitoring checks

Dizziness right now (0-10)?
Monitoring · Inform

Phases and exercise prescriptions

Phase 1 · T0

Habituate

3 weeks

Goals

Tolerate gaze drills 1 min
Reduce dizziness onset

Precautions

Sit if symptoms peak
Stop if nausea > 6/10

Ankle Alphabet (ABCs)

Mobility · T0 · Beginner

2 sets · 1 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Weight Shifts (Front/Back, Side/Side)

Balance · T0 · Beginner

2 sets · 15 reps · 60 sec · 30 sec rest

Recorded pain ceiling: 4/10

Ankle Circles

Mobility · T0 · Beginner

2 sets · 15 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Ankle Pumps

Mobility · T0 · Beginner

2 sets · 30 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Cat-Cow with Neck Focus

Mobility · T0 · Beginner

2 sets · 10 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Cervical Flexion (Chin to Chest)

Mobility · T0 · Beginner

2 sets · 8 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Cervical Rotation (Look Left/Right)

Mobility · T0 · Beginner

2 sets · 10 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Phase 2 · T1

Gaze Stabilisation

3 weeks

Goals

VOR x1 + x2 drills
Walk + look exercises

Precautions

Have support nearby
Do not drive immediately after sessions

Ankle Dorsiflexion Mobilization with Band

Mobility · T1 · Intermediate

2 sets · 15 reps · 60 sec · 30 sec rest

Recorded pain ceiling: 4/10

Clock Taps (Simple)

Balance · T1 · Beginner

2 sets · 2 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Band 4-Way Ankle

Stability · T1 · Beginner

2 sets · 15 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Anterior Ankle Stretch (Half-Kneeling)

Mobility · T1 · Beginner

2 sets · 5 reps · 20 sec · 30 sec rest

Recorded pain ceiling: 4/10

Foam Pad Balance (Double to Single Leg)

Balance · T1 · Intermediate

2 sets · 1 reps · 30 sec · 30 sec rest

Recorded pain ceiling: 4/10

Band Dorsiflexion

Stability · T1 · Beginner

2 sets · 15 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Calf Self-Massage (Foam Roller/Ball)

Mobility · T1 · Beginner

2 sets · 1 reps · 180 sec · 30 sec rest

Recorded pain ceiling: 4/10

Marching in Place

Balance · T1 · Beginner

2 sets · 1 reps · 45 sec · 30 sec rest

Recorded pain ceiling: 4/10

Band Eversion (Peroneals)

Stability · T1 · Beginner

2 sets · 15 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Cervical Extension (Look Up Gently)

Mobility · T1 · Beginner

2 sets · 6 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Single-Leg Stand (Eyes Open)

Balance · T1 · Beginner

2 sets · 1 reps · 30 sec · 30 sec rest

Recorded pain ceiling: 4/10

Band Inversion

Stability · T1 · Beginner

2 sets · 15 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Knee-to-Wall Dorsiflexion Rocks

Mobility · T1 · Beginner

2 sets · 10 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Single-Leg Stand with Head Turns

Balance · T1 · Intermediate

2 sets · 1 reps · 30 sec · 30 sec rest

Recorded pain ceiling: 4/10

Band Plantarflexion

Stability · T1 · Beginner

2 sets · 15 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Neck CARs (Controlled Articular Rotations)

Mobility · T1 · Intermediate

2 sets · 3 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Step-Through Walks (Push-Off Focus)

Balance · T1 · Beginner

2 sets · 1 reps · 300 sec · 60 sec rest

Recorded pain ceiling: 4/10

Chin Tuck Progression Series

Stability · T1 · Intermediate

2 sets · 10 reps · 0 sec · 30 sec rest

Recorded pain ceiling: 4/10

Phase 3 · T2

Balance Re-training

2 weeks

Goals

Tandem stance 30s eyes closed
Walk turns without staggering

Precautions

Practise in safe spaces

Neck Retraction with Eye Movement

Balance · T2 · Intermediate

2 sets · 1 reps · 90 sec · 30 sec rest

Recorded pain ceiling: 4/10

Ankle Eversion Walk

Strength · T2 · Intermediate

2 sets · 1 reps · 30 sec · 45 sec rest

Recorded pain ceiling: 4/10

Single-Leg Stand (Eyes Closed)

Balance · T2 · Intermediate

2 sets · 1 reps · 20 sec · 30 sec rest

Recorded pain ceiling: 4/10

Ankle Inversion Walk

Strength · T2 · Intermediate

2 sets · 1 reps · 30 sec · 45 sec rest

Recorded pain ceiling: 4/10

Star Excursion Taps (Y-Balance)

Balance · T2 · Intermediate

2 sets · 3 reps · 0 sec · 60 sec rest

Recorded pain ceiling: 4/10

Band Face Pull

Strength · T2 · Beginner

2 sets · 15 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Wobble Board Balance Holds

Balance · T2 · Intermediate

2 sets · 1 reps · 45 sec · 30 sec rest

Recorded pain ceiling: 4/10

Band Row

Strength · T2 · Beginner

2 sets · 12 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Band-Resisted Neck Extension

Strength · T2 · Intermediate

2 sets · 8 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Band-Resisted Neck Flexion

Strength · T2 · Intermediate

2 sets · 10 reps · 0 sec · 45 sec rest

Recorded pain ceiling: 4/10

Outcome measures

These are the measures linked to this module's current public record.

Pain Numeric Rating (0-10)

Simple · Required

Under clinical review

Patient-rated pain intensity over the last 24 hours.

Cadence: Baseline
Scale: 0–10 score
Scoring direction: Lower Better

Weekly Session Count

Simple · Optional

Under clinical review

Sessions completed in the last 7 days.

Cadence: Weekly
Scale: 0–14 sessions
Scoring direction: Higher Better

Dizziness Handicap Inventory

Prom · Optional

Under clinical review

DHI-25 total handicap score (higher = greater handicap).

Cadence: End Of Phase
Scale: 0–100 score
Scoring direction: Lower Better

Pain Numeric Rating (0-10)

Simple · Required

Under clinical review

Patient-rated pain intensity over the last 24 hours.

Cadence: End Of Program
Scale: 0–10 score
Scoring direction: Lower Better

Functional Limitation (0-10)

Simple · Required

Under clinical review

Self-rated difficulty performing daily tasks.

Cadence: Baseline
Scale: 0–10 score
Scoring direction: Lower Better

Borg Rating of Perceived Exertion

Simple · Optional

Under clinical review

Patient-reported exertion during a typical session.

Cadence: Weekly
Scale: 6–20 RPE
Scoring direction: Lower Better

Functional Limitation (0-10)

Simple · Optional

Under clinical review

Self-rated difficulty performing daily tasks.

Cadence: End Of Phase
Scale: 0–10 score
Scoring direction: Lower Better

Functional Limitation (0-10)

Simple · Required

Under clinical review

Self-rated difficulty performing daily tasks.

Cadence: End Of Program
Scale: 0–10 score
Scoring direction: Lower Better

Dizziness Handicap Inventory

Prom · Required

Under clinical review

DHI-25 total handicap score (higher = greater handicap).

Cadence: Baseline
Scale: 0–100 score
Scoring direction: Lower Better

Dizziness Handicap Inventory

Prom · Required

Under clinical review

DHI-25 total handicap score (higher = greater handicap).

Cadence: End Of Program
Scale: 0–100 score
Scoring direction: Lower Better

Timed Up & Go (seconds)

Functional · Required

Under clinical review

Seconds to rise from chair, walk 3m, turn, return, sit.

Cadence: Baseline
Scale: 0–60 seconds
Scoring direction: Lower Better

Timed Up & Go (seconds)

Functional · Required

Under clinical review

Seconds to rise from chair, walk 3m, turn, return, sit.

Cadence: End Of Program
Scale: 0–60 seconds
Scoring direction: Lower Better

Guide questions

What is the Vestibular Adaptation guide?

Gaze-stabilisation + Cawthorne-Cooksey progression for vestibular hypofunction. Nausea/dizziness gating built in.

Is this an individualized treatment plan?

No. This page is a public educational reference. Individualized use belongs in the authenticated safety-screening and clinician workflow.

Does this module require medical clearance?

Yes. The Vestibular Hypofunction record requires medical clearance before the interactive workflow can progress.

Has this guide completed clinical review?

No. One or more of the module, condition, or listed outcome measures is not marked approved, so this page is labelled under clinical review.

How is this rehabilitation pathway organized?

The current record contains 3 phases, a typical session length of 15 minutes, and an overall duration of 8 weeks.