Open AccessCanalith repositioning variations for benign paroxysmal positional vertigo
Author(s) -
Cohen Helen S.,
Haghpeykar Haleh Sangi
Publication year - 2010
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1016/j.otohns.2010.05.022
Subject(s) - benign paroxysmal positional vertigo , medicine , posturography , vertigo , otorhinolaryngology , physical therapy , posterior semicircular canal , physical medicine and rehabilitation , surgery , balance (ability) , audiology
OBJECTIVE To determine if variations in common treatments for benign paroxysmal positional vertigo (BPPV) affected efficacy. STUDY DESIGN Prospective, pseudo‐randomized study. SETTING Outpatient practice in a tertiary care facility. SUBJECTS AND METHODS Patients (n = 118) with unilateral BPPV of the posterior canal, including 13 patients with BPPV of the lateral canal, were tested at a tertiary care center on one of five interventions: canalith repositioning maneuver (CRP), CRP plus home exercise, modified CRP, CRP for patients with involvement of two semicircular canals, and self‐CRP home exercise. Self‐CRP was also compared to previously published data on efficacy of the Brandt Daroff exercise. Main outcome measures were vertigo intensity and frequency, presence/absence of Dix‐Hallpike responses, Vestibular Disorders Activities of Daily Living Scale (VADL), and computerized dynamic posturography. RESULTS Vertigo intensity and frequency and Dix‐Hallpike responses decreased significantly, and posturography and VADL improved significantly from pre‐to post tests. No other significant changes were found. The groups did not differ significantly. Vertigo intensity and frequency were not strongly related at pretest but were related at post‐test. Length of illness and age did not influence the results. CONCLUSION However the head is moved, as long as it is moved rapidly enough and through the correct planes in space, repositioning treatments are likely to be effective. Therefore, clinicians have a range of choices in selecting the treatment best suited for each patient's unique needs. © 2010 American Academy of Otolaryngology‐Head and Neck Surgery Foundation. All rights reserved.