Exercises targeting Anticipatory turning

Overall goal of the exercises

Improving the ability to turn the head and body fast in all directions without compromising safety or provoking dizziness.

Overall theme of the exercises

Practice free movement of the head in all daily tasks. Practice turning of the head and whole-body in all directions and orientations, promoting “top-down” movement strategies (i.e. moving the eyes, head, upper body and lower extremities in the stated order).

Additional considerations

Limitation in cervical range of movement can be addressed with additional interventions.

Turning can provoke severe dizziness in some patients. Exercises should be designed and progressed avoiding excessive dizziness during and after completing the exercises.

 

Key exercises Examples of progressions Examples of regressions

Turning the head to look at targets 

turning head

 

  • Standing while turning the head
  • Walking on the spot (with the back to a corner)
  • Walking (close to a wall or a table) 
  • Looking for various or moving targets
  • Sitting or touching a wall
  • Using only a few targets

Standing with the back or the front to a corner tossing a ball to the two walls in the corner (alternating between the walls)

tossing ball to corner

  • Hitting the walls with the ball in various places
  • Hitting the walls on two (or more) marks
  • Higher speed
  • Tossing upwards or/and to the floor
  • Stepping on the spot while tossing the ball
  • Walking few steps forward and backwards from the corner while tossing the ball
  • Standing with the back to only one wall, tossing the ball alternating between sides
  • Keeping hands close to the walls when tossing
  • Hitting the walls with the ball in preferred distance
  • Slower speed
  • Tossing to only one wall at the time (returning to neutral position after catching)
  • Using bigger ball

Bending under an obstacle

bending under

  • Using lower obstacle
  • Moving in continuous pattern of the figure eight (bending under in the center of the movement pattern)
  • Higher speed
  • Looking in the direction of the movement
  • Turning backwards (looking away from the direction of the movement)
  • Using higher obstacle
  • Small brake after each time of passing the obstacle
  • Slower speed
  • Looking in the preferred direction while turning
  • Touching a wall after turning

Executing turns standing in a corner

turning body

  • Higher speed
  • Touching lightly the corners after turning, alternation directions and which corner to touch
  • Tossing a ball after each turn (to the walls or upwards)
  • Slower speed
  • Executing incomplete turns (from facing one wall to facing the other wall)
  • Small brake after each turn

Tossing a balloon over the shoulder and turn to catch the balloon

turn to balloon

  • Keeping the balloon in the air after turning (controlling the balloon with light hits)
  • Turning in the opposite direction of tossing the balloon
  • Delaying the turn after tossing the balloon
  • Catching the balloon after each turn
  • Keeping the balloon in sight while turning (turning in the same direction of tossing the balloon)
  • Applying a smaller turning angle

Walking in the figure of eight while keeping focus on a fixed target

walking figure of 8

  • Using small figure of eight walking pattern
  • Placing the fixed target next to the “long” side of the walking pattern
  • Using multiple figure of eight walking pattern, walking around various objects
  • Walking around easily visible (high) objects
  • Using large figure of eight walking pattern
  • Placing the fixed target next to the “short” side of the walking pattern

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