When you come into clinic and your vestibular system is affected (i.e. your inner ear), chances are that we may use our vesticam as part of our assessment! The vesticam are infrared goggles that allow us to see a live video of your eyes while we do testing.

Benefits of using infrared goggles:
- Accurate assessment due to clients not being able to fixate their vision (which can suppress any underlying vestibular pathologies).
- Better able to see any nystagmus (rapid oscillations/flicking of eyes) present that may indicate certain vestibular or central pathologies present.
- Reduces risk of missing a potential diagnosis of pathology present.

​These are extremely beneficial for both clients and therapists to use to maximise assessment time and therefore improve the specificity of treatment for the client.

So often we have clients come in for an assessment for their vertigo and report that they have been trying to do the EPLEY maneuverer themselves at home (often repetitively each day) and it hasn’t been helping them.

The Epley maneuverer is a specific canal repositioning treatment maneuverer to treat BPPV in either the right or the left posterior semi-circular canal. The Epley can only be effective when it is used to treat the correct canal. In the inner ear we have 6 semi-circular canals, 3 on the right, and 3 on the left. Before the Epley is used to treat BPPV it’s really important that you are assessed first - to determine that you actually have BPPV, and then to establish which canal the BPPV is in.
If you do not know which canal the BPPV is in, then the Epley may not help to treat the BPPV or resolve your vertigo. There is also a risk that you can worsen your BPPV by shifting the crystals into another or multiple canals.

It is also important to also consider that your symptoms of vertigo or dizziness is not always a result of BPPV! Before undertaking any treatment it is really important to have an assessment to determine the root cause of your symptoms. Doing vestibular/vertigo treatments can provoke your symptoms more and can be traumatic for people - an experienced therapist can talk you through exactly what is happening and why you are experiencing your symptoms, and provide ongoing reassurance that you are safe when your body and symptoms tell you otherwise.

Once a diagnosis of BPPV has been established your vestibular therapist will then be able to prescribe any further canal repositioning manoeuvres to do at home, and give you individualised instructions on how to specifically for your BPPV.
Please get assessed for BPPV before you start doing the Epley at home! 

As we get older, our muscle strength reduces and there can be changes in our balance, mobility and fitness.

In the presence of adequate exercise, these changes in muscle strength and fitness with age are substantially attenuated.

Exercise is a preventive strategy for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits.

Exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, physical activity level, energy) and cognition, optimising functional capacity during ageing.

Here are the recommendations for older adults who are 65 years and older, being that of 150 minutes moderate cardio training each week, plus 2 strength trainings per week (according to the WHO's global recommendations). Remember that exercise should be individual to you, as everyone has different health conditions or circumstances, so this may need to be altered accordingly. If you are unsure or need help devising an appropriate programme, please contact us so we can help you!

For those who are interested, there is a great article (Expert Consensus Guidelines) that summarises recommendations according to various circumstances, including if you want to improve bone density specifically or help increase lean mass, for example, and discusses different modalities for each circumstance.

Izquierdo, M., Merchant, R.A., Morley, J.E. et al. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging 25, 824–853 (2021).