title: Treating Benign Paroxysmal Positional Vertigo in the Patient With Traumatic Brain Injury: Effectiveness of the Canalith Repositioning Procedure.
abstract: OBJECTIVE
  The aim of this study was to determine the effectiveness of the canalith repositioning procedure (CRP) in the treatment of benign paroxysmal positional vertigo (BPPV) among patients after mild-to-moderate traumatic brain injury.
  
  
  METHODS
  An unblinded, nonrandomized, case comparison interventional study with repeated measures (1, 5, 9, and 12 weeks postenrollment) of three groups of patients with traumatic brain injury (BPPV, n = 21; nonspecific dizziness, n = 23; no dizziness, n = 12) was conducted. Patients in the BPPV group received the CRP at baseline and repeatedly until a negative Dix-Hallpike Maneuver was observed. Participants in the other two groups did not receive the CRP.
  
  
  RESULTS
  Symptom resolution at the 12-week follow-up was observed in 75% of patients in the BPPV group versus 8.3% in the nonspecific dizziness group (p = .0006). A significant Group × Time interaction was observed for the Dizziness Handicap Inventory (F = 4.2, p = .003) and 36-item Short Form Health Questionnaire physical component scores (F = 2.16, p = .035) with the BPPV group showing significantly improved scores by the 12-week follow-up. Although there were between-group differences on the 36-item Short Form Health Questionnaire mental health component scores (F = 4.06, p = .022), changes over time were not significant in the groups.
  
  
  CONCLUSIONS
  Treatment with the CRP for posttraumatic BPPV resulted in significant symptom resolution and improvement in perceived physical health status.
authors.affiliation: Questions or comments about this article may be directed to Donna Ouchterlony, MD CCFP, at douchterlony@gmail.com. She is the Clinical Director, Head Injury Clinic, Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, and Assistant Professor, Family & Community Medicine, University of Toronto, Ontario, Canada. Cheryl Masanic, MD, is a Psychiatrist, Head Injury Clinic, Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, Ontario, Canada. Alicja Michalak, MScP MSN, is a Registered Nurse and the Head Injury Case Manager, Head Injury Clinic, Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, Ontario, Canada. Jane Topolovec-Vranic, PhD, is a Clinical Researcher, Trauma and Neurosurgery Program, Associate Scientist, and Li Ka Shing Knowledge Institute Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto; and an Associate Member, Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada. John A. Rutka, MD FRCSC, is a Clinical Neurotologist, Head Injury Clinic, Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, Ontario, Canada. We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated.
authors.forename: Donna
authors.initials: D
authors.lastname: Ouchterlony
authors.forename: Cheryl
authors.initials: C
authors.lastname: Masanic
authors.forename: Alicja
authors.initials: A
authors.lastname: Michalak
authors.forename: Jane
authors.initials: J
authors.lastname: Topolovec-Vranic
authors.forename: John A
authors.initials: JA
authors.lastname: Rutka
mesh_terms: D000328:Adult; D065635:Benign Paroxysmal Positional Vertigo / Q000209:etiology / Q000451:nursing / Q000628:therapy*; D000070642:Brain Injuries, Traumatic / Q000150:complications*; D004244:Dizziness / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D026741:Physical Therapy Modalities; D011446:Prospective Studies