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 Residual dizziness after successful repositioning maneuver for idiopathic benign paroxysmal positional vertigo: a review

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Giorgia Giommetti ◽  
Ruggero Lapenna ◽  
Roberto Panichi ◽  
Puya Dehgani Mobaraki ◽  
Fabrizio Longari ◽  
...  
Keyword(s):  
English Language ◽  
Benign Paroxysmal Positional Vertigo ◽  
Early Recognition ◽  
The Elderly ◽  
Vestibular Disorder ◽  
Risk Of Falling ◽  
Search Terms ◽  
Positional Vertigo ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

The benign paroxysmal positional vertigo (BPPV) is a vestibular disorder cause of vertigo. The BPPV may be corrected mechanically by repositioning maneuvers but even after successful maneuvers, some patients report residual dizziness for a certain period afterward. Early recognition and treatment might decrease the incidence of residual dizziness in patients with BPPV, especially in those patients with psychiatric comorbidities and in the elderly, lowering the risk of falling. Many pathogenetic hypotheses for residual dizziness are under debate. The purpose of this review was to identify, evaluate and review recent researches about possible causal factors involved in residual dizziness and the implications on clinical practice. A literature search was performed using different databases such as Pubmed and Scopus. The following search terms were used: <em>residual dizziness, otolithic membrane and BPPV</em>. The search found a total of 1192 titles, which were reduced to 963 after a procedure of de-duplication of the found titles. The research was then restricted to an interval of time comprised between 2000 and 2016 for a total of 800 titles. Among these titles, only those including the terms <em>benign paroxysmal positional vertigo</em> were considered eligible for this review. Only publications in English language were taken into consideration and we excluded those with not available abstract. Finally, 90 abstracts were obtained and critically evaluated by two different Authors, and additional studies were identified by hand searching from the references of artiche of interest. Only 53 were included in this work.

Vestibular Rehabilitation in Benign Paroxysmal Positional Vertigo

1995 ◽  
Vol 112 (5) ◽  
pp. P125-P125
Author(s):  
Ronald L. Steenerson ◽  
Gaye W. Cronin
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Rehabilitation ◽  
Success Rates ◽  
Appropriate Use ◽  
Educational Objectives ◽  
Rehabilitation Process ◽  
Positional Vertigo ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Educational objectives: To describe the vestibular rehabilitation process and the canalith repositioning maneuver, to understand the appropriate use and indications of these procedures, and to describe success rates in use of vestibular habituation exercises and canalith repositioning maneuvers.

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

scholarly journals Effectiveness of Particle Repositioning Maneuvers in the Treatment of Benign Paroxysmal Positional Vertigo: A Systematic Review

2010 ◽  
Vol 90 (5) ◽  
pp. 663-678 ◽  
Author(s):  
Janet Odry Helminski ◽  
David Samuel Zee ◽  
Imke Janssen ◽  
Timothy Carl Hain
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Benign Paroxysmal Positional Vertigo ◽  
The Self ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Positional Vertigo ◽  
Repositioning Maneuver ◽  
Paroxysmal Positional Vertigo

Background Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Purpose The purpose of this systematic review was to determine whether patients diagnosed with posterior canal (PC) BPPV, based on positional testing, and treated with a particle repositioning maneuver will show the resolution of benign paroxysmal positional nystagmus (BPPN) on the Dix-Hallpike Test performed 24 hours or more after treatment. Data Sources Data were obtained from an electronic search of the MEDLINE, EMBASE, and CINAHL databases from 1966 through September 2009. Study Selection The study topics were randomized controlled trials (RCTs), quasi-RCTs, the diagnosis of PC BPPV, treatment with the particle repositioning maneuver, and outcome measured with a positional test 24 hours or more after treatment. Data Extraction Data extracted were study descriptors and the information used to code for effect size. Data Synthesis In 2 double-blind RCTs, the odds in favor of the resolution of BPPN were 22 times (95% confidence interval=3.41–141.73) and 37 times (95% confidence interval=8.75–159.22) higher in people receiving the canalith repositioning procedure (CRP) than in people receiving a sham treatment. This finding was supported by the results reported in 8 nonmasked quasi-RCTs. Studies with limited methodological quality suggested that a liberatory maneuver (LM) was more effective than a control intervention; there was no significant difference in the effectiveness of the LM and the effectiveness of the CRP; the self-administered CRP was more effective than the self-administered LM; and the CRP administered together with the self-administered CRP was more effective than the CRP administered alone. The Brandt-Daroff exercises were the least effective self-administered treatments. Limitations The limitations included the methodological quality of the studies, the lack of quality-of-life measures, and confounding factors in reporting vertigo. Conclusions Randomized controlled trials provided strong evidence that the CRP resolves PC BPPN, and quasi-RCTs suggested that the CRP or the LM performed by a clinician or with proper instruction at home by the patient resolves PC BPPN. There were no data on the effects of the maneuvers on outcomes relevant to patients.

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)

scholarly journals Azithromycin in patients with Covid-19; a systematic review and metanalysis

2021 ◽  
Author(s):  
Luis Ayerbe ◽  
Ivo Forgnone ◽  
Carlos Risco-Risco ◽  
Maria Perez-Pinar ◽  
Salma Ayis
Keyword(s):  
Systematic Review ◽  
Clinical Severity ◽  
Future Research ◽  
Controlled Trials ◽  
Clinical Settings ◽  
Cochrane Central Register ◽  
Random Effects Models ◽  
Central Register ◽  
Significant Difference ◽  
Observational Design

Background: Azithromycin (AZM) has been widely used in the management of Covid-19. However, the evidence on its actual effects remains disperse and difficult to apply in clinical settings. This systematic review and metanalysis summarizes the studies on the beneficial and adverse effect of AZM in patients with Covid-19. Methods: The PRISMA 2020 statement criteria were followed. Randomized controlled trials (RCTs) and observational studies comparing clinical outcomes of patients treated, and not treated, with AZM, indexed until the 5th of July 2021, were searched in PubMed, Embase, The Web of Science, Scopus, The Cochrane Central Register of Controlled Trials, and MedRXivs. We used Random-effects models to estimate pooled effect size from aggregate data. Results: The initial search produced 4950 results. Finally, 16 studies, five RCTs and 11 with an observational design, with a total of 22984 patients, were included. The metanalysis showed no difference in mortality for those treated, or not, with AZM, OR: 0.95 (0.79-1.13). There was also no significant difference for those treated, and not, with AZM in need for hospital admission or time to admission from ambulatory settings, clinical severity, need for intensive care, or adverse effects. Conclusions: These results presented in this review do not support the use of AZM in the management of Covid-19. They also show that any harm caused to the patient who received it is unlikely. Future research on treatment for patients with Covid-19 may need to focus on other drugs

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