title: Efficacy of postural restriction in treating benign paroxysmal positional vertigo.
abstract: OBJECTIVE
  To investigate the efficacy of postural restriction after canalith repositioning in treating benign paroxysmal positional vertigo (BPPV).
  
  
  METHODS
  Prospective trial of patients with postural restriction vs those without postural restriction after treatment.
  
  
  METHODS
  Patients with classic BPPV and with BPPV without nystagmus were treated using the modified Epley canalith repositioning procedure. Patients were randomly separated into 2 groups. The first group was instructed to wear a cervical collar and to maintain an upright head position for 2 days. The second group had no motion restriction. After 5 days, the patients were followed up and evaluated using the Dix-Hallpike test.
  
  
  RESULTS
  In the first group, 56 of 62 ears healed after the first maneuver, and the remaining ears healed after the second. In the second group, 45 of 57 ears healed after the first maneuver, 6 after the second, and 5 (with subsequent postural restriction) after the third (1 ear did not improve). Five patients in the first group and 3 patients in the second group had BPPV without nystagmus; all of these patients healed after a single maneuver. The difference between the 2 groups in the number of maneuvers required for treatment was statistically significant (P<.05). The number of patients who required a third maneuver was significantly higher in the second group (P<.05).
  
  
  CONCLUSIONS
  Postural restriction enhances the therapeutic effect of canalith repositioning in the treatment of posterior semicircular canal BPPV. The long-term efficacy of postural restriction in preventing BPPV recurrence has not been demonstrated.
authors.affiliation: First Department of Otorhinolaryngology-Head and Neck Surgery, Sişli Etfal Research and Training Hospital, Istanbul, Turkey.
authors.forename: Burak O
authors.initials: BO
authors.lastname: Cakir
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ercan
authors.forename: Zeynep A
authors.initials: ZA
authors.lastname: Cakir
authors.forename: Suat
authors.initials: S
authors.lastname: Turgut
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001915:Braces; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D009759:Nystagmus, Pathologic / Q000503:physiopathology / Q000534:rehabilitation; D010037:Otolithic Membrane / Q000503:physiopathology*; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D019233:Retreatment; D055502:Secondary Prevention; D014717:Vertigo / Q000503:physiopathology / Q000534:rehabilitation*