The science behind The Oak Method

Research & sources:

Exercise is one of the best lifestyle recommendations for vestibular migraine management. Migraine needs movement in order to regulate hormones, levels of fatigue, brain health, and more. I will never force anyone to exercise, but I highly recommend exercise for vestibular migraine management, especially in a safe way!

• Exercise and migraine prevention: a review of the literature “addition of exercise to a traditional preventive regimen may provide added benefit”
• The link between migraine and physical exercise  “low physical activity levels are associated with higher prevalence and frequency of migraine and other headaches”
• What is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta-analysis of clinical trials “Strength training exercise regimens demonstrated the highest efficacy in reducing migraine burden, followed by high-intensity aerobic exercise.”

Strength training and other types of movement help improve your balance and reduce your risk of falls. Strength classes are taught by Dr. Madison Oak, Dr. Jenna Green, and Kelsey Voskamp.
Drs. Madison & Jenna are doctors of physical therapy and vestibular rehabilitation specialists and the leaders of vestibular group fit.

Kelsey Voskamp is a vestibular warrior, living with vestibular migraine and PPPD, as well as trained in taekwondo as a blackbelt, a certified fitness trainer, and Reiki. Learn more about Kelsey here

• Effects of resistance exercise on balance ability: systematic review and meta-analysis of randomized controlled trials “This finding has important practical implications, as RE could be used to improve both muscular strength and power, as well as balance at the same time.”
• Is aerobic exercise helpful in patients with migraine? A systematic review and meta-analysis “statistically significant differences in the decrease in pain intensity…, frequency and duration of migraine…, in the short-term. In addition, the meta-analysis showed statistically significant differences in the increase in quality of life.”

Strength training and other types of movement help improve your balance and reduce your risk of falls. Tai chi is taught by Dr. Jenna Green, PT, DPT, vestibular specialist and trained in Tai chi. Learn more about Dr. Jenna here.

• Tai chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: preliminary report “The TC group exhibited a positive relationship between change in leg mechanical energy expenditures and change in trunk velocity peak and range, while the VR group exhibited a negative relationship.”
  
• Tai chi for fall prevention and balance improvement in older adults: a systematic review and meta-analysis of randomized controlled trials “Tai chi is an effective exercise for preventing falls and improving balance ability in older adults, whether they are healthy or at high risk of falling.”

Yoga and pilates have been found to improve posture, increase cognition (goodbye brain fog)

• Yoga and cognition: a meta-analysis of chronic and acute effects: “Yoga practice appears to be associated with modest improvements in cognitive function”
• Effectiveness of yoga therapy for migraine treatment: a meta-analysis of randomized controlled studies: “The results revealed that compared with control group for migraine, yoga therapy was associated with remarkably decreased pain intensity…, headache frequency …, headache duration …, HIT-6 score  … and MIDAS score…

Pilates:

• Effect of mat pilates exercise on postural alignment and body composition of middle-aged women: “The pilates exercises are performed symmetrically and strengthen the deep muscles. Moreover, the results showed that muscle mass was correlated with trunk postural alignment and that the proper amount of muscle is critical in maintaining trunk postural alignment.”

We feature both ballet and ballroom style classes weekly. Dance has been shown to increase brain neuroplasticity, increase neurotropic factors, and improve brain volume and structures. All classes taught by our in house dance teacher, Bridgette who has a Bachelor of Fine Arts in Dance from the University of Arizona, and is a Vestibular Warrior. Read about Bridgette here. 

• Dance for neuroplasticity: A descriptive systematic review: “Functional changes included alterations in cognitive function such as significant improvement in memory, attention, body balance, psychosocial parameters and altered peripheral neurotrophic factor. Based on the evidence, dance practice integrates brain areas to improve neuroplasticity.”
• Influence of dance training on challenging postural control task: “
This research outlines dancers’ increased ability to modulate sensory weighting differently than non-dancers during postural task where somatosensory cues are reduced.”

Cardio has been shown to help reduce migraine frequency and intensity. Additionally, it is excellent and required for cardiovascular and brain health. Cardio classes are taught by Dr. Madison, Dr. Jenna, and Kelsey!
We feature a return to run program, or return to brisk walking. Additionally, we feature many cardio and HIIT style classes.

• What is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta-analysis of clinical trials: “Strength training exercise regimens demonstrated the highest efficacy in reducing migraine burden, followed by high-intensity aerobic exercise.“
• The effects of aerobic exercise intensity and duration on levels of brain-derived neurotrophic factor in healthy men: “Aerobic exercise caused a ~32% increase in serum BDNF in adult human males while serum BDNF decreased 13% in sedentary control subjects.” (remember when reading that most research is done on men. Although it’s unfair and inequitable, this is the research we must pull from and rely on for understanding how the body works).

If you have Postural Orthostatic Tachycardia syndrome it is incredibly important to exercise. We have a weekly supine or seated exercise class taught weekly with our in house POTS Specialist Physiotherapist, Trineta Bhojwani. Trineta is a Canadian physiotherapist who specializes in treating neurological conditions with a special interest in Vestibular Migraine, PPPD, and POTS. We will teach you about POTS, how to scale, and how to return to exercise in the POTS specific coursework and workouts.  Read about Trineta here!

• Exercise and non-pharmacological treatment of POTS: “Weight lifting starts from once a week, 15 to 20 minutes per session, and gradually increases to twice a week, 30 to 40 minutes per session. All resistance training sessions should be done on seated equipment, and the use of free weights needs to be avoided until the patient has become stronger and fitter.”
• Exercise in the Postural Orthostatic Tachycardia Syndrome: “Life-long training at a “dose” of at least 4–5 times per week has profound effects on cardiovascular structure and function and should be encouraged”

Your mind and your body are intimately connected, and contrary to popular belief, they will directly affect one another. The dizzy-anxious-dizzy cycle is VERY real, and is experienced by almost all vestibular warriors. You are not alone. In Vestibular Group Fit, we aim to break this cycle through critical thinking techniques and nervous system regulation exercises. You will be presented with many options for you to build the toolkit that works for you!

• Anxiety and depression among patients with different types of vestibular peripheral vertigo: “Clinical practice has demonstrated that many patients with vestibular peripheral vertigo also have depression/anxiety. The coexistence of these disorders could lead to a vicious circle and have a serious affect on the treatment efficacy and quality of life.”
• Anxiety and depression symptoms and migraine: a symptom-based approach research: “Lack of ability to properly control worrying and to relax are the most prominent issues in migraine psychiatric comorbidity.”
• Disability and anxiety in vestibular diseases: a cross-sectional study: “Vestibular disorders may trigger or cause anxiety because of dysfunctional circuitry in some areas including the amygdale, hippocampus, and infralimbic cortex.”

The way you think about your symptoms and your belief systems matter! We practice acceptance (the right way to do it), critical thinking, and more. Through the education pillar + critical thinking mindset work, you will be less fearful of the dizziness and therefore less anxious about the potential for symptoms. In turn, this causes a reduction in overall symptoms. Pain Reprocessing Therapy (PRT) is a well known treatment for those with chronic pain. We use techniques similar to those as pain-science and dizziness-science are incredibly similar in treatment.

• Cognitive behavioral principles in managing chronic disease: “…thinking ‘There is no point—nothing I do makes any difference’ will not only contribute to sadness but also is likely to increase the avoidance of activities. This in turn will lower energy levels, which further depresses mood (and so on)”
• Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain: “Psychological treatment centered on changing patients’ beliefs about the causes and threat value of pain may provide substantial and durable pain relief for people with Chronic Back Pain.”

Critical thinking helps you be more mindful and present, which ultimately leads to less stress and less anxiety and therefore less dizziness.

• Stress management: “A focus on the present moment can potentially help decondition habitual reaction patterns and increase response flexibility. From a cognitive perspective, this suggests that viewing present circumstances as new and unique experiences increases one’s capacity for generating multiple alternative response options. Mindfulness also may address cognitive-behavioral factors, such as self-focused attention, experiential avoidance, and perceived control.”

** This is not therapy nor is it a replacement for psychological therapies or other sorts of medical or psychological treatment**

Regulating your nervous system is an important daily practice as chronic stress can be detrimental to brain plasticity and chronic dizziness. Sometimes medication is needed, but other times it is not. This is going to be up to you and your body. However, the non-medication option will be explored here in Vestibular Group Fit in order to give you all the resources you need to find a new sense of calm, and a regulated nervous system. This is necessary for vestibular compensation & habituation, and therefore less dizziness.

• Interactions between stress and vestibular compensation – a review: “However repeated exposure to stressful stimuli or chronic stress can lead to an inhibition of brain plasticity and lasting detrimental changes in the hippocampus, amygdala, and prefrontal cortex”
• Autonomic dysfunction in chronic persistent dizziness: “Autonomic dysfunction is frequently found in patients with chronic persistent dizziness”
• Stress management: “With practice, individuals learn to process emotions, thoughts, and sensations as they arise. Individuals learn to modify their reflexive conditioning from automatically reacting or worrying about the future to a more adaptive, measured response with greater awareness of the present moment.[6] The literature is replete with evidence suggesting that, with practice, individuals can become more mindful, increasing their capacity to fully process emotions, thoughts, and sensations as they arise.”

Yoga Nidra is a form of yogic sleep and is offered every other week in Vestibular Group Fit, taught by our in house yoga teacher, Candy Price. Candy is a certified 200 hour  yoga teacher, Certified Personal Trainer with NASM, Ayurveda Certification, and an Associate of Science Degree. Candy is passionate about offering Yoga Nidra to Vestibular Warriors for increased relaxation, a reduction in fatigue levels, and reduction in anxiety symptoms. Learn more about candy here.

• The origin and clinical relevance of yoga nidra: Clinical studies have shown that yoga nidra meditation is associated with positive physiological changes, including improvements in several hematological variables, red blood cell counts, blood glucose levels, and hormonal status. Two neuroimaging studies have shown that yoga nidra produces changes in endogenous dopamine release and cerebral blood flow, a further confirmation that its effects on the CNS are objectively measurable.
• The impact of yoga nidra and seated meditation on the mental health of college professors: Studies have found that the Yoga Nidra practice (or “state”) appears to reflect an integrated response by the hypothalamus, resulting in decreased sympathetic (excitation) nervous activity and increased parasympathetic (relaxation) function. Results show that there was a significant improvement in positive well-being, general health, and vitality in the yoga nidra group.

Taking time for meditation and relaxation daily is so important. There are not studies about meditation and vestibular disorders, so we can expand from research on meditation and other chronic illnesses. Meditation classes are taught by Candy, and Dr. Madison.

• Can meditation influence quality of life, depression, and disease outcome in multiple sclerosis?: “Findings from a large international web-based study: The study reveals a significant association between meditation, lower risk of depression, and improved HRQOL in people with MS.”
• Meditation’s impact on chronic illness: Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress.

The way you breathe and your pattern of breathing is the fastest way to access your nervous system and provide a parasympathetic response (rest and digest) to your body. It’s fast, it’s free, and it’s effective! There’s no one side fits all for breathing, though, which means we provide multiple types of breathing throughout your coursework!

• Breathwork interventions for adults with clinically diagnosed anxiety disorders: a scoping review: A range of breathwork interventions yielded significant improvements in anxiety symptoms in patients clinically diagnosed with anxiety disorders.
• How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing: Slow breathing techniques act enhancing autonomic, cerebral and psychological flexibility in a scenario of mutual interactions: we found evidence of links between parasympathetic activity (increased HRV and LF power), CNS activities (increased EEG alpha power and decreased EEG theta power) related to emotional control and psychological well-being in healthy subjects.

You deserve a support group that shows recovery stories, hope, and more! Too many support groups focus on what you cannot do, or what you should avoid. We know that having a vestibular disorder doesn’t need to prevent you from living your best life. Let’s focus on what you can do.

• Impact and experiences of vestibular disorders and psychological distress: Qualitative findings from patients, family members and healthcare professionals: Coping strategies were thought to help empower patients to self‐manage their symptoms and regain a sense of control, but these require oversight from healthcare providers.
• Effectiveness of support groups to improve the quality of life of people with idiopathic pulmonary fibrosis a pre-post test pilot study: Subjects with disabling chronic conditions, together with their family members, are among the categories of people who benefit most from support groups. The effectiveness of a support group is based on the ability to reduce isolation through contact and interaction with others, on the opportunity of intimate conversations that permit the expression of emotions and discussions, on the ability to change perceptions and lead to a more balanced and positive view of the participants’ status, and finally on the opportunity to improve adaptive coping strategies, also through learning from the experience of others.

** this group is based 100% on Facebook and can only be accessed with an account. If you don’t have an FB account, you may make one with a slightly different name, let me know the name, and participate that way.

Understanding your vestibular disorder and having fast access to your questions 100% of the time is vital to your health journey here. Coaching via zoom is efficacious for learning, understanding, and bettering your health!

• Do people with existing chronic conditions benefit from telephone coaching? A rapid review: Telephone coaching for people with chronic conditions can improve health behaviour, self-efficacy and health status. This is especially true for vulnerable populations who had difficulty accessing health services. There is less evidence for improvements in quality of life and patient satisfaction with the service.

Coaching calls are all via zoom, have a topic for education, and will also have approximately 40 minutes for Group Q&A!

When you live with a chronic illness, you want to know everything you can about your chronic illness. And, you want reputable information as quickly as you can get it. And, most people who live with a vestibular disorder report to us that they don’t understand their disorder, why it’s happening, or even what is happening in their bodies. That’s where we come in. We believe every person with a vestibular disorder should be supported completely in their educational journey with their vestibular disorder, and that all the answers should come from qualified professionals. Although nothing in Vestibular Group Fit is ever medical advice, we will always answer your questions in an educational fashion, that actually makes sense!

• Preferences and experiences of people with chronic illness in using different sources of health information: results of a mixed-methods study: Almost half of the … respondents with chronic illness did not understand explanations given by a health professional at least once in the last 12 months. Difficulties in comprehension occur most frequently in communication with doctors.

** For more on education and Q&A, scroll down to the Education section below!**

Knowledge is power. Education is not sexy or exciting, but it is ESSENTIAL. If you don’t know what’s going on with your chronic illness, it’s harder to want to make changes, and nearly impossible to understand why and which changes are needed. We provide a comprehensive education in The Oak Method, to ensure you have all the answers to all your questions, or the resources to point you in the right direction.

• Empowering patients: promoting patient education and health literacy: To improve the physical and psychosocial wellbeing of a patient, personalized patient education handouts, in addition to verbal education by the HCPs, augment the betterment of patient care via shared decision making and by improving patient satisfaction and health literacy.
• Moving into action: the master key to patient education: Study findings provide a complete picture of patient education and challenge managers to develop new strategies to plan and implement appropriate changes.

Self efficacy is your belief in yourself to make change. We believe in you, and want you to believe in you! Nothing changes unless something changes, right? (Cliche, we know! But, it’s true!!). We want to instill self-efficacy in you so you can change your life, and get back to everything we know you want to do, without the dizziness!

• Promoting self‐efficacy in patients with chronic disease beyond traditional education: a literature review: Four prominent strategies were found to promote self‐efficacy: self‐management programmes, telehealth, mobile applications, gaming and social media. The findings indicate self‐efficacy for patients with chronic conditions can improve with new interventions. Enhancing traditional education and boosting self‐efficacy could increase treatment adherence and decrease cost.
• Increasing access to chronic disease self-management programs in rural and remote communities using telehealth: Improvements in self-efficacy, health status, and health behaviors were equally effective in single- and multi-site groups. Access to self-management programs could be greatly increased with telehealth using single- and multi-site groups in rural and remote communities.

• We believe, as we said above, that you deserve to understand your body. You should understand your vestibular system. You should understand your vestibular disorder. You can feel better, there are options to heal. Educating yourself makes symptoms less scary, and helps you make changes while understanding what changes need to be made and the WHY. Currently, our healthcare system is not set up to help you manage chronic conditions.
• Is there time for management of patients with chronic diseases in primary care?: Current practice guidelines for only 10 chronic illnesses require more time than primary care physicians have available for patient care overall. Streamlined guidelines and alternative methods of service delivery are needed to meet recommended standards for quality health care.

Not only do you deserve the education, but you deserve it now, not in 3-6 months when the doctor can finally see you. You deserve to start your healing journey today. Although VGFit is not medical advice, the advice and education offered in your membership will kickstart your healing journey.

• Waiting for care: chronic illness and health system uncertainties in the United States: Timely access to care is important for ensuring desirable health outcomes, reducing financial burden from seeking nonnetwork care and possibly more distant healthcare, and improving patients’ perception of need and experience with the healthcare system