Cawthorne-Cooksey Exercises 

Timothy C. Hain, MD Last update: January 21, 2008 Return to VRT page

One of the first "general" interventions for vestibular problems were the Cawthorne-Cooksey exercises, as shown below. These are a one page handout of activities that progress from simple head movement to complex activities such as throwing a ball. Click here for a general discussion of vestibular rehabilitation.

Cawthorne Cooksey Exercises

1. In bed or sitting
   1. Eye movements -- at first slow, then quick
      1. up and down
      2. from side to side
      3. focusing on finger moving from 3 feet to 1 foot away from face
   2. Head movements at first slow, then quick, later with eyes closed
      1. bending forward and backward
      2. turning from side to side.
2. Sitting
   1. Eye movements and head movements as above
   2. Shoulder shrugging and circling
   3. Bending forward and picking up objects from the ground
3. Standing
   1. Eye, head and shoulder movements as before
   2. Changing from sitting to standing position with eyes open and shut
   3. Throwing a small ball from hand to hand (above eye level)
   4. Throwing a ball from hand to hand under knee
   5. Changing from sitting to standing and turning around in between
4. Moving about (in class)
   1. Circle around center person who will throw a large ball and to whom it will be returned
   2. Walk across room with eyes open and then closed
   3. Walk up and down slope with eyes open and then closed
   4. Walk up and down steps with eyes open and then closed
   5. Any game involving stooping and stretching and aiming such as bowling and basketball

Diligence and perseverance are required but the earlier and more regularly the exercise regimen is carried out, the faster and more complete will be the return to normal activity. Ideally these activities should be done with a supervised group. Individual patients should be accompanied by a friend or relative who also learns the exercises.

(Adapted from Dix and Hood, 1984 and Herdman, 1994; 2000)

• Cawthorne, T: The Physiological Basis for Head Exercises. The Journal of The Chartered Society of Physiotherapy 30:106, 1944.
• Cawthorne T. Vestibular injuries. Proc R Soc Med 1946;39:270-272.
• Cooksey FS. Rehabilitation in vestibular injuries. Proc R Soc Med 1946;39:273-275