title: The efficacy of vestibular rehabilitation in patients with benign paroxysmal positional vertigo: a rapid review.
abstract: OBJECTIVE
  To systematically review the evidence on the effectiveness of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo.
  
  
  METHODS
  A literature search was performed in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and EMBASE databases.
  
  
  METHODS
  A comprehensive search was performed up to July 2013. Two authors independently scanned the search results to identify randomized controlled trials of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. We included trials that were available in the English language and did not apply publication year or publication status restrictions. Studies were methodologically assessed using the Cochrane risk of bias tool. Primary outcome was the effect on vertigo attacks and balance.
  
  
  RESULTS
  Of 76 identified trials, only 2 trials fulfilled our inclusion criteria and were included in this review, involving 106 patients. One study was methodologically weak, the other strong. The studies differed in type of intervention, type of outcome, and follow-up time. Both studies reported no significant difference in the vertigo intensity between groups. A small effect was found on balance.
  
  
  CONCLUSIONS
  Two level II studies in benign paroxysmal positional vertigo showed no effect of vestibular rehabilitation in addition to a canalith repositioning maneuver on vertigo intensity and a small, beneficial effect on balance. We therefore conclude that there is no evidence for an effect of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo.
authors.affiliation: Apeldoorn Dizziness Centre, Gelre Hospitals, Apeldoorn, The Netherlands e.horst@gelre.nl.
authors.forename: Ellis S
authors.initials: ES
authors.lastname: van der Scheer-Horst
authors.affiliation: Apeldoorn Dizziness Centre, Gelre Hospitals, Apeldoorn, The Netherlands.
authors.forename: Peter Paul G
authors.initials: PP
authors.lastname: van Benthem
authors.affiliation: Apeldoorn Dizziness Centre, Gelre Hospitals, Apeldoorn, The Netherlands.
authors.forename: Tjasse D
authors.initials: TD
authors.lastname: Bruintjes
authors.affiliation: Apeldoorn Dizziness Centre, Gelre Hospitals, Apeldoorn, The Netherlands.
authors.forename: Roeland B
authors.initials: RB
authors.lastname: van Leeuwen
authors.affiliation: Apeldoorn Dizziness Centre, Gelre Hospitals, Apeldoorn, The Netherlands.
authors.forename: Hester J
authors.initials: HJ
authors.lastname: van der Zaag-Loonen
mesh_terms: D065635:Benign Paroxysmal Positional Vertigo / Q000534:rehabilitation*; D006801:Humans
keywords: benign paroxysmal positional vertigo; physiotherapy; vertigo; vestibular rehabilitation