BRANDT-DAROFF EXERCISES

The Brandt-Daroff exercise is one of several exercises intended to speed up the compensation process and end the symptoms of vertigo. It often is prescribed for people with benign paroxysmal positional vertigo (BPPV) and sometimes for labyrinthitis. These exercises will not cure these conditions, but over time they can reduce symptoms of vertigo.

The Brandt-Daroff exercise is done as follows:

� Sit on the edge of a bed or sofa, and quickly lean to the side that causes the worst vertigo. You should end up lying on your side with your ear down.

· Remain in this position until either the vertigo goes away or 30 seconds have passed.

· Sit up. If this causes vertigo, wait for it to stop. Repeat the procedure on the other side.

These exercises are performed in three sets per day for two weeks. In each set, one performs the maneuver as shown five times.

1 repetition = maneuver done to each side in turn (takes 2 minutes)

Start sitting upright (position 1). Then move into the side-lying position (position 2), with the head angled upward about halfway. An easy way to remember this is to imagine someone standing about 6 feet in front of you, and just keep looking at their head at all times. Stay in the side-lying position for 30 seconds, or until the dizziness subsides if this is longer, then go back to the sitting position (position 3). Stay there for 30 seconds, and then go to the opposite side (position 4) and follow the same routine.

These exercises should be performed for two weeks, three times per day, or for three weeks, twice per day. This adds up to 42 sets in total. In most persons, complete relief from symptoms is obtained after 30 sets, or about 10 days. In approximately 30 percent of patients, BPPV will recur within one year. Unfortunately, daily exercises are not effective in preventing recurrence (Helminski and Hain, 2008).

When performing the Brandt-Daroff maneuver, caution is advised should neurological symptoms (i.e. weakness, numbness, visual changes other than vertigo) occur. Occasionally such symptoms are caused by compression of the vertebral arteries (Sakaguchi et al, 2003). In this situation we advise not proceeding with the exercises and consult your physician.