We previously wrote about;

Habituation ; Adapting to overcome dizzy

In this article we ask you to consider;

Do habituation exercises, proclaimed by some within our industry for both adult and paediatric patients with vestibular disorders, actually activate habituation mechanisms?

Most people believe that habits are formed by completing a task for 21 days in a row. Habit formation is the process by which new behaviours become automatic. For example, smokers instinctively reach for a cigarette the moment they wake up in the morning (even though we know it is bad for their health).

This learning process is acquired passively.

Our health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Those living with a vestibular disorder seek rehabilitation processes and guidance to adapt to overcome their dizzy state. (reference http://dizzinessbalancedisorders.com.au/?p=871 )

In in this previous article, we asked readers to consider; learning a new routine or adapting to our condition is what is required by many during the vestibular rehabilitation process…

The physiological mechanisms underlying habituation and adaptation are different.

Many encourage habituation methods; however, it is a multi-factorial phenomenon and a form of behavioural plasticity.

As we mentioned, this learning process is acquired passively. Meaning, by presenting the same stimulus or environment repeatedly until the response has been extinguished. It is a central process that is independent of sensory adaptation and motor fatigue (Thompson and Spencer (1966,) and less commonly used in adult and paediatric Vestibular rehabilitation.

For example, the apparent decrease in our perception of speed during a long journey in a motor vehicle and adjusting to motion sickness on rough seas within several days, are examples of habituation.

The physiological mechanisms underlying habituation is due to the decrease of the excitatory nerve messages from one cell to another cell by chemicals whereas the retention of habituation is by the formation of new messengers and new proteins which modify the small gap between two nerve cells across which nerve impulses (messages) travel.

This phenomenon is known as Hebbian plasticity.

Based on the above, the habituation exercises currently being expounded by some in our industry for patients with vestibular loss, is at odds with the definition of habituation. This is because these exercises are performed actively by the patients, thereby stimulating feedback and feed forward mechanisms.

Once again, we stress, as therapists, our aim is to teach our patients new strategies and sensory substitution, and we encourage the brain to engage and reorganise itself to cope with this apparent new loss of function.