Answer:

“Box breathing is a sympathetic de-stimulation exercise. And so, basically, we have a sheet of paper and we also have an app that can be on a computer screen that forms a box. So they’ll breathe in for four seconds on this part of the box, hold their breath for four seconds, breathe out for four seconds, and hold their breath for four seconds. And so it’s a way for patients to reduce that sympathetic response, to ground a little bit, and it can really help with self-awareness and calming their symptoms, especially when there’s that anxiety component.”

This is a sample video given to a patient with motion sensitivity as part of their home program (includes box breathing):

This video should not be performed without guidance from a skilled clinician with experience in visually induced dizziness.

Instructions: This home program includes a video to help motion sensitivity that is triggered by busy places, the grocery store, scrolling on your computer, etc.

Please watch the video while:

• lying on your back
• sitting
• standing

Ideally, this exercise would be done on a large TV screen but you can use your computer screen if it is 15” or bigger. This will most likely not be helpful if you watch it on your phone. The video does include some instructions in it. You will see stripes moving in the following direction(s):

• to the right
• to the left
• switching between right and left

The stripes will move for 10 seconds in this video and a blue dot will randomly move around the screen. Follow the dot with your eyes while keeping your head still. After 10 seconds, you will be asked to perform a deep breathing exercise, called “box breathing.” This sequence will be repeated for a total of 3 repetitions in the video.

You may have an increase in symptoms. If you do, rest and see if your symptoms go back to the intensity when you started within 5-10 minutes. If your symptoms do not decrease, you may want to try the exercise later in the day or the next day.

Ideally, you want to do this exercise up to 3 times per day. Once you can tolerate this exercise without a significant increase in symptoms, we will increase the time you watch the stripes.

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RESOURCES & LINKS:

• This Q&A is an excerpt from the Vestibular Health Summit Sessions
• The Vestibular Health Summit Sessions are included with 360NeuroGO Enterprise

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FACULTY:

Kendal Reddell, PT, DPT, NCS

​Kendal Reddell has a doctorate in physical therapy and is an American Physical Therapy Association Board Certified Clinical Neurologic Specialist. She also holds a certificate of competency in the evaluation and treatment of vestibular disorders from Emory University. Kendal is a Parkinson’s Wellness Recovery (PWR!) and LSVT BIG certified therapist, specializing in treating individuals with Parkinson’s disease. Dr. Reddell is a proud graduate of Tarleton State University where she competed in NCAA Women’s Basketball. She received her Doctorate in Physical Therapy from the University of Texas Southwestern Medical School in 2010, and has worked in a variety of settings specializing in brain injury, stroke, Parkinson’s Disease, and vestibular disorders.

Alex Tarabbia, PT, DPT

Alex Tarabbia has a Doctorate in Physical Therapy. She developed a passion for vestibular therapy when volunteering at a specialty balance clinic in her college years. This passion grew while working with patients with vestibular disorders through graduate level clinical internships, as well as taking advanced coursework in vestibular therapy in graduate school. Prior to joining the 360 Balance & Dizziness team, Dr. Tarabbia worked with patients with a variety of orthopedic injuries and balance and mobility impairments in the outpatient setting. Dr. Tarabbia completed her undergraduate work at Gordon College, in Massachusetts, graduating Summa Cum Laude with a Bachelor’s degree in Kinesiology. She received her Doctorate in Physical Therapy from the University of St. Augustine, in Austin, Texas.