title: Are postural restrictions necessary for management of posterior canal benign paroxysmal positional vertigo?
abstract: OBJECTIVE
  An important component of management of benign paroxysmal positional vertigo (BPPV) has been the application of postural restrictions after use of a canalith repositioning maneuver (CRM) to prevent the return of otolithic debris into the posterior semicircular canal (PSC). This study was designed to explore the effectiveness of postural restrictions in patients with BPPV caused by otolithic debris in the PSC.
  
  
  METHODS
  Seventy-four adult patients with unilateral PSC BPPV were enrolled into this study. All patients were managed with a CRM--either the modified Epley maneuver or the Semont maneuver. The patients were divided randomly into 2 groups: group A, with postural restrictions, and group B, without postural restrictions. The statistical analysis was performed with X2 tests and t-tests.
  
  
  RESULTS
  No patients in either group showed positional nystagmus in the posttreatment evaluation under infrared videonystagmoscopy. No patients had symptoms of vertigo after the therapy. The results of follow-up vestibular tests were normal in both groups.
  
  
  CONCLUSIONS
  In our experience, postural restrictions do not enhance the beneficial effect of the CRMs. They do not seem to have any protective role and therefore should not be recommended as an adjunct to the treatment of PSC BPPV.
authors.affiliation: Ear, Nose and Throat Institute, Department of Surgical, Clinical and Experimental Sciences, Postgraduate School of Public Health and Preventive Medicine, d'Annunzio University of Chieti-Pescara, Chieti, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Stefano
authors.forename: Francesco
authors.initials: F
authors.lastname: Dispenza
authors.forename: Leonardo
authors.initials: L
authors.lastname: Citraro
authors.forename: Anna Grazia
authors.initials: AG
authors.lastname: Petrucci
authors.forename: Pamela
authors.initials: P
authors.lastname: Di Giovanni
authors.forename: Gautham
authors.initials: G
authors.lastname: Kulamarva
authors.forename: Navneet
authors.initials: N
authors.lastname: Mathur
authors.forename: Adelchi
authors.initials: A
authors.lastname: Croce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D065635:Benign Paroxysmal Positional Vertigo; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014717:Vertigo / Q000517:prevention & control / Q000628:therapy*; D055815:Young Adult