The effect of postural restrictions in the treatment of benign paroxysmal positional vertigo

• Published in: European archives of oto-rhino-laryngology Vol. 262; no. 5; pp. 408 - 411
• Main Authors: Moon, Seok Jin, Bae, Soon Ho, Kim, Hee Dae, Kim, Jung Hyun, Cho, Yong Bum
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.05.2005
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Non tumoral diseases; Otorhinolaryngology. Stomatology; Physical Therapy Modalities; Posture; Recurrence; Retrospective Studies; Sex Factors; Treatment Outcome; Vertigo - therapy; Human; Repositioning maneuver; Nervous system diseases; Position; Internal ear disease; Postural restrictions; Benign paroxysmal vertigo; Benign paroxysmal positional vertigo; Equilibrium disorder; Treatment; Semicircular canal; ENT disease; Posterior semicircular canal
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-004-0836-7

The treatment of benign paroxysmal positional vertigo (BPPV) consists of a repositioning maneuver in order to remove otoliths from the posterior semicircular canal and subsequent postural restrictions to prevent debris from reentering the canal. However, the extent to which postural restrictions affect the final outcomes of BPPV is still uncertain. The purpose of this study is to determine the effects of postural restrictions in the treatment of BPPV, which is caused by otoliths in the posterior semicircular canal, and to evaluate its usefulness as a therapy. Seventy cases diagnosed as BPPV of the posterior semicircular canal were studied. All patients were treated utilizing the modified Epley maneuver. They were divided into two groups. The first group (group A, 35 patients) was instructed to sleep in a semi-sitting position and to avoid moving their heads forward or backward, whereas no instructions were given to the second group (group B, 35 patients). The information gathered from the patients was analyzed by age of onset, gender, duration of the disease and cure rates or recurrence rates. In group A, the average age was 54.5 years and the mean duration of symptoms was 116.5 days, whereas in group B, these measurements were 54.8 years and 86.7 days. The cure rates were 91.4 and 94.3%, respectively. Symptoms recurred in 12.5% of group A patients, while in group B, there was a 9.1% recurrence rate. Our study did not show any significant difference between the two groups. Postural restriction therapy, practiced after the modified Epley repositioning maneuver, did not have a significant effect on the final outcomes of BPPV. Based on our results, we do not recommend this therapy since there was no significant benefit for the patients who utilized postural restrictions.