The Additional Effect of Vestibular Rehabilitation Therapy on Residual Dizziness After Successful Modified Epley Procedure for Posterior Canal Benign Paroxysmal Positional Vertigo

2021 ◽  
pp. 1-9
Author(s):  
Maryam Heydari ◽  
Mohsen Ahadi ◽  
Bahram Jalaei ◽  
Mohammad Maarefvand ◽  
Hossein Talebi
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Short Form ◽  
Vestibular Rehabilitation ◽  
Control Group ◽  
Symptom Scale ◽  
Posterior Canal ◽  
Rehabilitation Therapy ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Paroxysmal Positional Vertigo

Purpose The aim of the study was to evaluate the additional effect of vestibular rehabilitation therapy (VRT) compared with the modified Epley procedure alone on residual dizziness after a successful modified Epley procedure in patients with posterior canal benign paroxysmal positional vertigo (BPPV). Method In this cross-sectional analytical comparative study, 47 patients (35 women and 12 men) aged 18–80 years with posterior canal BPPV were randomly assigned to one of two following groups: the control group, who received the modified Epley procedure only, and the VRT group, who received the modified Epley procedure plus vestibular rehabilitation for 4 weeks. Outcome measures, including the Dizziness Handicap Inventory (DHI), the Vertigo Symptom Scale–Long Version (VSS-L), and the Vertigo Symptom Scale–Short Form (VSS-SF), were conducted on the same session before initial therapy (T1), at 48 hr later (T2), and at 4 weeks later (T3). Presence or absence of residual dizziness was evaluated at T2. Results Residual dizziness was found in 20 (42.6%) patients after a successful modified Epley procedure. There was no statistically significant difference between the mean DHI, VSS-L, and VSS-SF scores at T1, T2, and T3 in patients who manifested with residual dizziness and those without residual dizziness in both groups. The average DHI, VSS-L, and VSS-SF score reduced during the time in both groups. These results were demonstrated that the VRT group and the control group have similar reductions in symptoms after treatment with the VRT plus modified Epley procedure and the modified Epley procedure only, respectively. Conclusions Residual dizziness is a common condition after a successful modified Epley procedure for BPPV. The VRT plus modified Epley procedure is as effective as modified Epley procedure alone in the management of residual dizziness. Further studies with supervised and customized VRT and longer follow-up periods are needed. Supplemental Material https://doi.org/10.23641/asha.14825508

The Efficacy of Vestibular Rehabilitation in Patients with Benign Paroxysmal Positional Vertigo

2014 ◽  
Vol 151 (5) ◽  
pp. 740-745 ◽  
Author(s):  
Ellis S. van der Scheer-Horst ◽  
Peter Paul G. van Benthem ◽  
Tjasse D. Bruintjes ◽  
Roeland B. van Leeuwen ◽  
Hester J. van der Zaag-Loonen
Keyword(s):  
English Language ◽  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Rehabilitation ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Positional Vertigo ◽  
Central Register ◽  
Significant Difference ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Objective To systematically review the evidence on the effectiveness of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. Data Sources A literature search was performed in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and EMBASE databases. Review Methods A comprehensive search was performed up to July 2013. Two authors independently scanned the search results to identify randomized controlled trials of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. We included trials that were available in the English language and did not apply publication year or publication status restrictions. Studies were methodologically assessed using the Cochrane risk of bias tool. Primary outcome was the effect on vertigo attacks and balance. Results Of 76 identified trials, only 2 trials fulfilled our inclusion criteria and were included in this review, involving 106 patients. One study was methodologically weak, the other strong. The studies differed in type of intervention, type of outcome, and follow-up time. Both studies reported no significant difference in the vertigo intensity between groups. A small effect was found on balance. Conclusion Two level II studies in benign paroxysmal positional vertigo showed no effect of vestibular rehabilitation in addition to a canalith repositioning maneuver on vertigo intensity and a small, beneficial effect on balance. We therefore conclude that there is no evidence for an effect of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo.

scholarly journals The Association Between Serum Vitamin D Levels and Benign Paroxysmal Positional Vertigo

2021 ◽  
pp. 014556132110085
Author(s):  
Kanokporn Sarsitthithum ◽  
Tosapohn Wisupagan ◽  
Sivaporn Kiatthanabumrung ◽  
Chanchai Jariengprasert
Keyword(s):  
Vitamin D ◽  
Benign Paroxysmal Positional Vertigo ◽  
Serum Vitamin ◽  
Control Group ◽  
P Value ◽  
Serum Vitamin D ◽  
Positional Vertigo ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Paroxysmal Positional Vertigo

Objective: This study aimed to evaluate the association between serum vitamin D levels and benign paroxysmal positional vertigo (BPPV). Participants and Methods: This prospective study consisted of 137 participants. There were 69 participants in the BPPV group compared with 68 healthy participants. Blood samples from both groups were collected from all participants to assess serum vitamin D levels. Results: No significant difference in demographic data between BPPV and control groups. The results showed that the mean serum vitamin D levels in the BPPV group was lower than that of the control group ( P value = .001). Among BPPV participants, there was no statistically significant difference between mean serum vitamin D levels of participants with recurrent BPPV, and that of newly diagnosed BPPV participants ( P value = .313). Conclusion: A statistically significant association between lower mean serum vitamin D levels in the BPPV group compared with that of the control group. Therefore, low serum vitamin D levels may be one of the risk factors for BPPV.

scholarly journals Comparision of Video Head Impulse Test Findings Before and After Therapy Maneuvers in Individuals with Benign Paroxysmal Positional Vertigo

2021 ◽  
Author(s):  
ERCAN KARABABA ◽  
Hacı Hüseyin DERE ◽  
Banu MÜJDECİ ◽  
Erkan KARATAŞ
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Impulse Test ◽  
Control Group ◽  
Study Group ◽  
Video Head Impulse Test ◽  
Head Impulse ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Before And After ◽  
Paroxysmal Positional Vertigo

Purpose: Vestibuloocular reflex (VOR) may be helpful in the diagnosis of Benign Paroxysmal Positional Vertigo (BPPV). Video Head Impulse Test (vHIT) can effectively diagnose VOR deficits in vestibular disorders. Aims: The aim of this study is to investigate the significance of vHIT in determining the efficacy of therapeutic maneuvers in individuals with posterior semicircular canal BPPV. Materials and Methods: The study included 25 patients with posterior SCC BPPV (Study Group) between the ages of 19-65 years, 30 healthy individuals (Control Group). All individuals underwent otorhinolaryngologic examination, audiological evaluation with, videonystagmography and vHIT. The Dizziness Handicap Inventory (DHI) and Visual Analogue Scale (VAS) were administered to the individuals with posterior SCC BPPV for the intensity of dizziness and Modified Epley maneuver was performed 3 times at an interval of 3 days. The vHIT, DHI and VAS were re-administered to these individuals 1 week after improvement was detected in positional nystagmus. Results: There was no significant difference between the study and control groups in terms of vHIT gains for all bilateral SCCs before therapeutic maneuver (p>0.05). In the study group, there was no significant difference between vHIT gains of all bilateral SSCs before and after therapeutic maneuvers (p>0.05). No asymmetry or refixation saccades (overt and covert) were observed in any of the individuals in both groups during all measurements. Compared to before therapeutic maneuvers, there was a significant decrease in dizziness-related disability level assessed by DHI and intensity of dizziness assessed by VAS in the study group after the improvement (p<0.001). Conclusion: It was found that vHIT was not a diagnostic test in BPPV and in terms of evaluating the efficacy of therapeutic maneuvers. Subjective evaluations determining the intensity of dizziness and level of dizziness-related disability in BPPV provided supportive information in diagnosis and in determining the efficacy of therapeutic maneuvers.

scholarly journals Self-Treatment of Posterior Canal Benign Paroxysmal Positional Vertigo: A Preliminary Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhuangqin Gan ◽  
Shiling Zhou ◽  
Hui Yang ◽  
Feng He ◽  
Dong Wei ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Benign Paroxysmal Positional Vertigo ◽  
Residual Symptoms ◽  
Resolution Rate ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Epley Maneuver ◽  
Preliminary Study ◽  
Paroxysmal Positional Vertigo

Objectives: The purpose of this study is to investigate a modified Epley maneuver for self-treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV).Methods: The study recruited 155 patients with PC-BPPV. All patients were randomized into the Epley maneuver group (n = 77) and modified Epley maneuver group (n = 78). We analyzed the resolution rate (1 day and 1 week), residual symptoms after the maneuver, and adverse effects.Results: It was found that the modified Epley maneuver group had a higher resolution rate than that of the Epley maneuver group in the treatment of PC-BPPV after 1 day of the initial maneuver (p &lt; 0.05). However, there was no difference in resolution rate between the Epley maneuver group and the modified Epley maneuver group in resolution rate after 1 week of the initial maneuver (p &gt; 0.05). The modified Epley maneuver group had fewer residual symptoms than that of the Epley maneuver group 1 week after treatment of PC-BPPV (p &lt; 0.05). Significant improvements were also observed in average DHI scores in patients who underwent the modified Epley maneuver compared to the Epley maneuver (p &lt; 0.05). There was no significant difference in adverse effects between the two groups (p &gt; 0.05).Conclusions: The modified Epley maneuver has a satisfactory therapeutic efficacy with less residual symptoms and could be recommended as a self-treatment for patients with PC-BPPV.

scholarly journals Comparison of effectiveness of Cawthorne Cooksey exercise with Brandt Daroff exercise in managing post Epley’s residual dizziness in patients with posterior canal benign paroxysmal positional vertigo

2021 ◽  
Vol 7 (11) ◽  
pp. 1750
Author(s):  
Sunil K. S. Bhadouriya ◽  
Shaili Priyamvada ◽  
Hukam Singh
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Disorder ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Comparison Of Effectiveness ◽  
Peripheral Vertigo ◽  
Paroxysmal Positional Vertigo

<p class="abstract"><strong>Background:</strong> Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo.  Vertigo and balance disorders are among the most common symptoms experienced in patients who visit ENT outpatient department.  BPPV is a common vestibular disorder leading to significant morbidity and psychosocial impact. Residual dizziness is a common condition that manifests as persistent disabling imbalance after successful repositioning maneuvers for BPPV.</p><p class="abstract"><strong>Methods: </strong>In this study we analysed and compared the effectiveness of Cawthorne Cooksey Exercise with Brandt Daroff Exercise to treat residual dizziness after successful Epley’s maneuver for posterior canal benign paroxysmal positional vertigo. A total of 30 subjects with residual dizziness after successful Epley’s maneuver for posterior canal BPPV were included in our study, 10 were male and 20 were female. The Group A received the Cawthorne Cooksey exercise post Epley’s maneuver and Group B received the Brandt Daroff exercise post Epley’s maneuver. </p><p class="abstract"><strong>Results:</strong> We conclude that both the groups have significant improvement in their symptoms and balance. This was indicated by the results.  Despite the significant results within the groups, there was no significant difference between the groups, means both exercises showed almost equal improvement in their respective group.</p><p><strong>Conclusions: </strong>This<strong> </strong>study concludes that both Cawthorne Cooksey exercise and Brandt Daroff exercise are helpful in treating residual dizziness after successful Epley’s maneuver in posterior canal BPPV patients. These exercises are safe and able to reduce subjective symptoms and imbalance hence, any of these can be recommended for treating post Epley’s residual dizziness in patients with posterior canal BPPV.  </p>

scholarly journals Vestibular rehabilitation therapy in elderly with benign paroxysmal positional vertigo

2020 ◽  
Vol 5 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Yeny Concha Cisternas ◽  
Eduardo Guzmán-Muñoz
Keyword(s):  
Quality Of Life ◽  
Physical Therapy ◽  
Vestibular System ◽  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Rehabilitation ◽  
Rehabilitation Therapy ◽  
Positional Vertigo ◽  
High Prevalence ◽  
Paroxysmal Positional Vertigo

The vestibular system contributes to the maintenance of the bipedal posture and balance. Peripheral vestibular alterations such as paroxysmal positional benign vertigo have high prevalence in elderly, being responsible for a large number of falls, which can cause disability and death. It has been shown that repositioning maneuvers and physical therapy aimed at restoring balance have good results in reducing symptoms, and also improve the quality of life of elderly.

Vestibular Rehabilitation

2019 ◽  
Vol 4 (6) ◽  
pp. 1378-1378
Author(s):  
Neil T. Shepard
Keyword(s):  
Physical Therapy ◽  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Rehabilitation ◽  
Balance Disorders ◽  
Rehabilitation Therapy ◽  
Basic Area ◽  
Positional Vertigo ◽  
Balance Rehabilitation ◽  
Paroxysmal Positional Vertigo

Purpose In this introduction, the author introduces the reader to two articles that cover the basic area of vestibular and balance rehabilitation therapy (VBRT). The articles explain some of the uses of VBRT but not the techniques of how to establish such a program for a patient with dizziness and balance disorders. Conclusion The audiologist needs to be familiar with the various uses of VBRT and the techniques for identification and treatment of benign paroxysmal positional vertigo. However, without the audiologist undergoing further specific musculoskeletal training, the remainder of VBRT should occur in the physical therapy arena.

Effects of balance Vestibular Rehabilitation Therapy in elderly with Benign Paroxysmal Positional Vertigo: a randomized controlled trial

2016 ◽  
Vol 39 (12) ◽  
pp. 1198-1206 ◽  
Author(s):  
Karyna Myrelly Oliveira Bezerra de Ribeiro ◽  
Raysa Vanessa de Medeiros Freitas ◽  
Lidiane Maria de Brito Macedo Ferreira ◽  
Nandini Deshpande ◽  
Ricardo Oliveira Guerra
Keyword(s):  
Randomized Controlled Trial ◽  
Benign Paroxysmal Positional Vertigo ◽  
Controlled Trial ◽  
Vestibular Rehabilitation ◽  
Rehabilitation Therapy ◽  
Randomized Controlled ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Effects of customized vestibular rehabilitation plus canalith repositioning maneuver on gait and balance in adults with Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial

2021 ◽  
pp. 1-8
Author(s):  
Phui Lin Se To ◽  
Devinder Kaur Ajit Singh ◽  
Susan L. Whitney
Keyword(s):  
Randomized Controlled Trial ◽  
Benign Paroxysmal Positional Vertigo ◽  
Controlled Trial ◽  
Vestibular Rehabilitation ◽  
Posterior Canal ◽  
Randomized Controlled ◽  
Positional Vertigo ◽  
Dynamic Gait ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

BACKGROUND: Adults with unilateral posterior canal benign paroxysmal positional vertigo (BPPV) may continue to present with residual dizziness and balance impairments after the canalith repositioning maneuver (CRM). Customized Vestibular rehabilitation (VR) in addition to the standard CRM may improve postural control in adults with BPPV. However, the effectiveness of this intervention for improving dyanmic gait measures in adults with BPPV is unknown. OBJECTIVE: We aimed to determine the effectiveness of customized VR in addition to the standard CRM on dynamic gait measures among adults with unilateral posterior canal BPPV. METHODS: In this double blind, randomized controlled trial, 28 adults with BPPV were randomized to either control (n = 14, age: 54.36±8.55) or experimental (n = 14, age: 50.71±9.88) groups. The experimental and control groups received customized VR plus standard CRM for six weeks and standard CRM for two weeks respectively. Dynamic gait measures (duration of a complete gait cycle, stride velocity, turning duration and number of steps while turning) were recorded using a portable mobility sensor (iTUG) at baseline, week 4 and 6. A mixed model ANOVA was used to estimate the main effects of the interventions. RESULTS: During walking, a group effect was demonstrated on gait duration, stride velocity, turning duration and number of steps while turning (p <  0.05). CONCLUSIONS: Six weeks of customized VR performed in addition to the standard CRM was more effective than the standard CRM alone in improving balance and gait in adults with posterior canal BPPV. (252 words)

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