REFERENCE · RECOVERY TECHNIQUE
Returning to Places and Activities That Matter
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When this may fit: When dizziness has made a valued outing difficult and a practical, supported version could be explored. [Individualized participation planning within rehabilitation; standalone efficacy uncertain]
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For the Person With FND
You may miss the ordinary parts of going out: choosing your own groceries, seeing a friend or sitting somewhere different. Community practice starts with what you want back. It is not a demand to visit the busiest shop to prove you can cope.
What is different about practising in a real place?
An outing combines movement, visual detail, sound, standing, navigation and travel. A clinic exercise may not show how all of those demands interact. Practising a chosen part of the outing can reveal which change would make it more accessible. [1]
For example, the first useful version of visiting a café could be a quiet time, a nearby seat and transport both ways. Takeaway with a friend may be the right alternative on another day. Neither requires symptoms to disappear before the experience counts.
Make a plan small enough to use
- Choose the activity and the part you most value. Decide what can be shortened, delegated or changed.
- Plan transport, seating, toilets, an easy exit and any help or mobility equipment. Include the journey home in the energy and symptom budget.
- Agree a stopping point in advance. Leaving when you planned can be a successful trial.
- Afterwards, note what made participation possible and any later cost. Keep helpful adaptations before considering a further change.
There is no set number of outings or fixed increase. A reasonable plan also accounts for migraine, fatigue, sensory symptoms and other conditions. These are illustrative participation strategies, not a standardized exposure protocol. [1][2]
Access and practice are different needs
Delivery services, remote meetings, accessible transport and wheelchairs can meet everyday needs while you work on a separate rehabilitation goal. Do not turn every necessary outing into therapy. If an environment is still too much, practical alternatives are valid; improvement is not measured by how little help you accept.
During a familiar flare
Change the plan, shorten the outing or stay with an accessible alternative. Repeated setbacks should prompt a review of the demands and contributors, not an automatic conclusion that fear is stopping you.
When to stop and seek assessment
Stop unsafe activity. Sudden or distinctly different dizziness with new weakness, double vision, speech trouble, inability to walk, severe headache, fainting or chest pain needs urgent assessment. Sudden hearing loss, head injury or persistent vomiting also needs prompt medical attention. Increasing falls or progressive loss of function warrants reassessment. Existing PPPD does not explain every new symptom. See the diagnostic and differential-assessment page.
For the Person With FND
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For Family, Friends, and Other Supporters
Agree whether your role is company, transport, carrying items or helping leave. Keep the exit plan even if the outing is going well. Avoid surprise detours and praise participation in the terms the person values rather than endurance.
During a familiar flare, follow the agreed support and safety plan. Ask before taking over. New or substantially different symptoms need their own assessment; an exercise should never delay that care.
For the Person With FND
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For Clinicians and the Care Team
Use ecological goals and distinguish task practice from access to essential services. Account for transport, environmental load, orthostatic symptoms, sensory intolerance and delayed effects. If fear is relevant, address it collaboratively without interpreting all avoidance or reduced activity as fear-driven.
Agree an accessible next step and review point. Consider meaningful activity, safety, access, effort and delayed effects alongside dizziness severity. Limited improvement is not grounds to withdraw assistance or infer lack of effort.
For the Person With FND
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For Clinicians and the Care Team
Research and Sources
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Research and Sources
This page expands original entry 7, Graded community activity. Examples and practical prompts are educational adaptations, not patient quotations or a reproduced treatment protocol. Original-entry numbering does not imply thirteen independently validated treatments.
Activity planning and real-world practice are represented in clinical programmes. These examples are adaptations for participation; no cited trial establishes this exact outing sequence or a required exposure dose.
| Citation | Source | What it supports and its limits | Figure |
|---|---|---|---|
| 1 | FND-CIT-0192 — Herdman D, Norton S, Murdin L, Frost K, Pavlou M, Moss-Morris R. The INVEST trial: a randomised feasibility trial of psychologically informed vestibular rehabilitation versus current gold standard physiotherapy for people with Persistent Postural Perceptual Dizziness. Journal of Neurology. 2022;269:4753–4763. DOI. | Small feasibility comparison of treatment packages; does not establish component efficacy or ACT benefit. | — |
| 2 | FND-CIT-0196 — Neurosymptoms.org. Functional Dizziness (PPPD). Specialist patient information. Accessed September 22, 2026. | Specialist explanation and treatment context; not a controlled treatment trial. | — |
Sources checked: September 22, 2026 · Vestibular, neurological, lived-experience and accessibility review pending
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
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