title: The impact of diabetes on mobility, balance, and recovery after repositioning maneuvers in individuals with benign paroxysmal positional vertigo.
abstract: OBJECTIVE
  The prevalence of benign paroxysmal positional vertigo (BPPV) is higher in people with type 2 diabetes (DM). The impact of DM on mobility, balance, and management of BPPV is unknown. This prospective study compared symptom severity, mobility and balance before and after the canalith repositioning maneuver (CRM) in people with posterior canal BPPV canalithiasis, with and without DM.
  
  
  METHODS
  Fifty participants, BPPV (n=34) and BPPV+DM (n=16) were examined for symptom severity (dizziness handicap inventory, DHI), mobility (functional gait assessment, FGA), and postural sway (using an accelerometer in five conditions) before and after the CRM. The number of maneuvers required for symptom resolution was recorded.
  
  
  RESULTS
  At baseline, no differences in DHI or FGA scores were seen between groups, however, people with BPPV+DM had higher sway velocity in the medio-lateral direction in tandem stance (p<0.01). After treatment, both groups improved in DHI and FGA scores (p<0.01), with no differences between groups. Decrease in sway velocity in the mediolateral direction (p=0.003) were seen in tandem stance in persons with BPPV+DM. There were no differences between the groups in the number of CRMs provided.
  
  
  CONCLUSIONS
  This pilot study showed no differences in symptom severity, mobility deficits or efficacy of CRM treatments in people with posterior canal BPPV canalithiasis with and without DM. Future studies examining the impact of the severity and duration of diabetes, as well as the influence of diabetic peripheral neuropathy on functional performance are essential.
authors.affiliation: Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160. Electronic address: ldsilva@kumc.edu.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: D'Silva
authors.affiliation: University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA 15260; Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Whitney
authors.affiliation: Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160.
authors.forename: Marcio
authors.initials: M
authors.lastname: Santos
authors.affiliation: Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.affiliation: Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS 66160.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kluding
mesh_terms: D061725:Accelerometry; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D065635:Benign Paroxysmal Positional Vertigo / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D004244:Dizziness / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation; D015444:Exercise / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055805:Moving and Lifting Patients / Q000379:methods*; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D012720:Severity of Illness Index
keywords: Canalith repositioning maneuvers; Functional mobility; Positional vertigo; Postural sway; Type 2 diabetes