Body Stabilization in Benign Paroxysmal Positional Vertigo

Abstract

Objective: Evaluate the influence of Benign Paroxysmal Positional Vertigo (BPPV) in the balance control of the elderly after Epley’s maneuver and understand whether a reposition maneuver is enough to recover balance control. Method: Prospective study of 33 elderly patients with vertical canal BPPV seen in a tertiary center. Dizziness Handicap Inventory (DHI) and static posturography were determined before and after Epley’s maneuver. The parameters of the Balance Rehabilitation Unit (BRU) static posturography analyzed were: the limit of stability (LOS) and body sway velocity (VOS). Results: The DHI total and the subscale scores improved ( P = .001) after the treatment in all aspects. There was statistically significant improvement of the LOS pre- and posttreatment ( P = .001). Eight of 10 visual-vestibular stimuli had statistically significant improvement after treatment: with eyes closed ( P = .001); over foam and eyes closed ( P = .002); saccadic stimulation ( P = . 043); horizontal optokinetic stimulation ( P = .015); 2 different verticaloptokinetic stimulations ( P = . 003, P = . 009); two different visual-vestibular stimulations ( P = .003, P = .047). The VOS showed statistical significance after treatment for eyes closed ( P = .001); on foam and eyes closed ( P = .005); horizontal optokinetic stimulus ( P = .042); vertical optokinetic stimulus ( P = .027); horizontal visual vestibular stimulus ( P = .002); vertical visual vestibular stimulus ( P = .018). Conclusion: Elderly patients with BPPV present impairment of static postural control in vestibular conflicts. The maneuver promotes remission of symptoms, increases the limit of stability, and improves the control of postural balance in the conditions of somatosensory, visual, and visual-vestibular conflicts.