Canalith repositioning variations for benign paroxysmal positional vertigo.
OBJECTIVE
To determine if variations in common treatments for benign paroxysmal positional vertigo (BPPV) affected efficacy.


METHODS
Prospective, pseudo-randomized study.


METHODS
Outpatient practice in a tertiary care facility.


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.


CONCLUSIONS
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.
Cohen
Helen S
HS
Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA. hcohen@bcm.edu
Sangi-Haghpeykar
Haleh
H
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D056888:Patient Positioning; D011446:Prospective Studies; D020127:Recovery of Function; D012648:Self Care; D012665:Semicircular Canals; D016896:Treatment Outcome; D014717:Vertigo / Q000503:physiopathology / Q000628:therapy*