title: The effect of postural restrictions in the treatment of benign paroxysmal positional vertigo.
abstract: 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.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, Chonnam National University Medical School, 8 Hakdong Dong-gu, Gwangju, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Moon
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Bae
authors.forename: Hee Dae
authors.initials: HD
authors.lastname: Kim
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Cho
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011187:Posture; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014717:Vertigo / Q000628:therapy*