Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo

Daniela Patricia Vaz,Juliana Maria Gazzola,Solange Martiliano Lança,Ricardo Schaffeln Dorigueto,Cristiane Akemi Kasse

doi:10.5935/1808-8694.20130027

Abstract

Benign paroxysmal positional vertigo (BPPV) may compromise the balance of elderly subjects. ObjectiveTo observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance. MethodThis is a prospective clinical study. Patients diagnosed with BPPV (Dix-Hallpike test) were submitted to the Timed Up & Go (TUG) test, the Clinical Test of Sensory Interaction and Balance (CTSIB), and lower limb testing before and after they were repositioned using the modified Epley maneuver. Resultsmost subjects were females, and the group's mean age was 70.10 years (SD = 7.00). All patients had canalithiasis of the posterior canal. The following symptoms improved after the maneuver: postural instability (p = 0.006), nausea and vomiting (p = 0.021), and tinnitus (p = 0.003). Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver (p < 0.001). Patients performed better on the CTSIB after the Epley maneuver on condition 2 (p < 0.003), condition 3 (p < 0.001), condition 4 (p < 0.001), condition 5 (p < 0.001), and condition 6 (p < 0.001). ConclusionClinical and functional aspects of body balance in elderly with BPPV improved after treatment with the modified Epley maneuver.

Highlights

Dizziness is a highly prevalent symptom among the elderly, and has been considered as a geriatric syndrome[1]
Patients diagnosed with Benign paroxysmal positional vertigo (BPPV) (Dix-Hallpike test) were submitted to the Timed Up & Go (TUG) test, the Clinical Test of Sensory Interaction and Balance (CTSIB), and lower limb testing before and after they were repositioned using the modified Epley maneuver
Clinical and functional aspects of body balance in elderly with BPPV improved after treatment with the modified Epley maneuver

Summary

Introduction

Dizziness is a highly prevalent symptom among the elderly, and has been considered as a geriatric syndrome[1]. Along with body balance alterations, they account for 5% to 10% of the visits to medical clinics every year and involve 40% of the subjects aged 40 and above[2]. Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. BPPV is observed in 64/100,000 people, with even higher prevalence rates among the elderly. It is estimated that 25% of the subjects affected by dizziness aged 70 and above have BPPV. Most tend to live with it for over a year before seeking help[3]. The most widely accepted pathophysiological substrate is the one originated by the detachment of statoconia from the utricular macula that may adhere to the cupula (cupulolithiasis) or circulate freely in the endolymph in the ducts of the semicircular canals (canalithiasis)[4,5]

Methods

Results

Conclusion