Question: I had a cerebellar lesion which was removed. I can't change direction quickly without losing my balance. I can walk very quickly if it's in a straight line, but if I need to zig, zag, I lose my balance and can easily fall.

Anybody know of good exercises that don't cause loss of balance or dizziness? -- R., California

Answer: I've got a good exercise for balance that I do with someone else.

Take two poles, broom handles or the like, about five to six feet long. Face each other and each hold a pole in each hand. First at waist level, the "normal" person uses gentle changes in force to try and throw the VHL-er off balance, who then tries to maintain balance. Not twisting and pulling really hard, but back and forth, changing the forces at play, alternating pulls and pushes between the two.

A more difficult exercise advanced from the above is to hold the poles at shoulder level.

Another thing I have found helpful is Tai Chi, which emphasizes balance and shifting weight from one foot/leg to the other.

Once I was able to walk/run fairly easily, I have found running slowly while pushing a soccer ball to be great practice.

What was explained to me is that the cerebellum is the most simple part of the brain, and that it retrains itself. The key to getting your balance back after a deficit is to practice. Balance and motion are learned responses, not reflexes. It is possible to gain back much of what is lost.

Hope this was some help. Again, I'm not a doctor or a physical therapist, these are just my own experiences. -- Brian D., Kentucky

Note from Physical Therapist:

Brian, the exercises that you recommended for balance are great. I actually do the broomstick one with patients that have low back pain so that they can learn to control their trunk motion and strengthen their abdominal muscles. I have had patients stand on an uneven surface, i.e. foam or a balance board, and then toss a ball to me. Just standing at the kitchen sink on one foot, holding on with as few fingers as possible works too.

I would recommend that someone with severe balance problems get professional assistance in the beginning or work with someone who can spot you, work with you, in case you fall. -- Deb Hogan, P.T., Massachusetts

As printed in the VHL Family Forum 8:4, December 2000. For permission to reprint, please contact VHL Family Alliance, editor@vhl.org. Further information is available from the VHL Family Alliance, info@vhl.org.