Postural Restriction in Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial

Authors

  • Yuvatiya Plodpai Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Pattarawadee Prayuenyong Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.2020776

Keywords:

BPPV, posterior semicircular canal, postural restriction, vertigo

Abstract

Objective: We compared the efficacy between addition of post-maneuver postural restriction, and that of the modified Epley’s maneuver alone. 

Material and Methods: One hundred eighty patients with posterior canal benign paroxysmal positional vertigo were divided into two groups, using a block of four randomization. Group A were instructed to avoid head movement for 48 hours after the modified Epley’s maneuver. Group B were treated with the modified Epley’s maneuver alone. Dix- Hallpike test and dizziness handicap inventory (DHI) scores were assessed at 1 and 2 weeks, and followed up for 48 weeks to assess recurrent symptoms.

Results: There were no significant differences between the two groups in terms of changes from a positive to a negative Dix-Hallpike test; while the DHI score and recurrence rate were significantly lower in group A (p-value 0.042).

Conclusion: Postural restriction after the modified Epley’s maneuver can improve the DHI score, and reduce the recurrence rate of vertigo, compared with the modified Epley’s maneuver alone.

References

Kim JS, Zee DS. Benign paroxysmal positional vertigo. N Engl J Med 2014;370:1138-47.

von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 2007;78:710-15.

Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ 2003; 169:681-93.

Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 2017;156:S1-47.

Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992;107:399-404.

Cakir BO, Ercan I, Cakir ZA, Turgut S. Efficacy of postural restriction in treating benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg 2006;132:501-5.

Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 1990; 116:424-7.

Devaiah AK1, Andreoli S. Postmaneuver restrictions in benign paroxysmal positional vertigo: an individual patient data metaanalysis. Otolaryngol Head Neck Surg 2010;142:155-9.

Balikci HH, Ozbay I. Effects of postural restriction after modified Epley maneuver on recurrence of benign paroxysmal positional vertigo. Auris Nasus Larynx 2014;41:428-31.

Moon SJ, Bae SH, Kim HD, Kim JH, Cho YB. The effect of postural restrictions in the treatment of benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 2005;262:408-11. 11. Casqueiro JC, Ayala A, Monedero G. No More Postural Restrictions in Posterior Canal Benign Paroxysmal Positional Vertigo. Otol Neurotol 2008;29:706-9.

Mostafa BE, Youssef TA, Hamad AS. The necessity of postmaneuver postural restriction in treating benign paroxysmal positional vertigo: a meta-analytic study. Eur Arch Otorhinolaryngol 2013;270:849-52.

Li S, Tian L, Han Z, Wang J. Impact of postmaneuver sleep position on recurrence of benign paroxysmal positional vertigo. PLoS One 2013;8. doi: 10.1371/journal.pone.0083566.

Shim DB, Kim JH, Park KC, Song MH, Park HJ. Correlation between the head-lying side during sleep and the affected side by benign paroxysmal positional vertigo involving the posterior or horizontal semicircular canal. Laryngoscope 2012; 122:873-6.

Cakir BO, Ercan I, Cakir ZA, Civelek S, Turgut S. Relationship between the affected ear in benign paroxysmal positional vertigo and habitual head-lying side during bedrest. J Laryngol Otol 2006;120:534-6.

Hunt WT, Zimmermann EF, Hilton MP. Modifications of the Epley (canalith repositioning) manoeuvre for posterior canal benign paroxysmal positional vertigo (BPPV). Cochrane Database Syst Rev 2012;4:CD008675.

Lopez-Escamez JA, Gamiz MJ, Fernandez-Perez A, Gomez- Finana M. Long-term outcome and health-related quality of life in benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 2005;262:507–11.

Downloads

Published

2022-03-15

How to Cite

1.
Plodpai Y, Prayuenyong P. Postural Restriction in Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial. J Health Sci Med Res [Internet]. 2022 Mar. 15 [cited 2024 Dec. 23];39(3):201-6. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/255247

Issue

Section

Original Article