“Positive to Negative” Dix-Hallpike test and Benign Paroxysmal Positional Vertigo recurrence in elderly undergoing Canalith Repositioning Maneuver and Vestibular Rehabilitation

Ribeiro, Karyna Mirelly Oliveira Bezerra de Figueiredo; Ferreira, Lidiane Maria de Brito Macedo; Freitas, Raysa Vanessa de Medeiros; Silva, Camila Nicácio da; Deshpande, Nandini; Guerra, Ricardo Oliveira

doi:10.1055/s-0036-1572528

Cited by 11 publications

(8 citation statements)

References 42 publications

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“…Also supporting previous findings, 2 , 20 , 33 , 34 women outnumbered men in our study, which is consistent with the higher prevalence of pc-BPPV in women. 35 , 36 , 37 , 38 No significant differences between men and women were found in terms of response to the EM during follow-up, even though baseline DHI-S scores were higher among women. Sex was not a significant factor in the multivariate model.…”

Section: Discussionmentioning

confidence: 85%

A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with pc-BPPV: A randomised controlled trial in primary care

et al. 2021

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Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment is the Epley manoeuvre (EM). Objective The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability. Design Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Participants Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix–Hallpike test (DHT) were randomised to: Interventions Intervention (EM) group or a control (sham manoeuvre) group. Main measurements The main study covariates were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory – screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years. standard deviation, 16.98) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men ( P < .001). Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusions Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale.

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Section: Discussionmentioning

confidence: 85%

A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with pc-BPPV: A randomised controlled trial in primary care

et al. 2021

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“…One article 30 used Semont Liberatory Maneuver (SLM) as the intervention, while four studies used Epley maneuver 20 , 31 , 32 , 33 and one study implemented movement restrictions after the ORM and used a cervical collar and a mini-vibrator applied on the mastoid of the affected side. 31 Four studies applied VR exercises 20 , 32 , 33 , 34 and two articles applied pharmacotherapy. 30 , 34 Table 1 provides details about the intervention strategies used in each study.…”

Section: Resultsmentioning

confidence: 99%

“…The analyzed variables in the selected studies included: vertigo, 20 , 30 , 32 , 33 positional nystagmus 20 and postural balance, 33 the number of necessary maneuvers for remission of symptoms 31 , 32 and the quality of life by Dizziness Handicap Inventory (DHI) score, 31 , 33 and functionality by the Vestibular Disorders Activities of Daily Living scale (VDADL). 30 , 34…”

Section: Resultsmentioning

confidence: 99%

“…As for the ORM intervention in elderly, most studies applied the modified Epley maneuver. 20 , 31 , 32 , 33 No study used the classic Epley maneuver, but the study of André et al 31 added a mini-vibrator on the mastoid process of the affected side. All the studies that used modified Epley maneuver described improvements in BPPV symptomatology, mainly for vertigo, dizziness and nystagmus.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Otolith Repositioning Maneuvers and Vestibular Rehabilitation exercises in elderly people with Benign Paroxysmal Positional Vertigo: a systematic review

Ribeiro

Oliveira

Freitas

et al. 2018

Brazilian Journal of Otorhinolaryngology

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There was a trend of improvement in Benign Paroxysmal Positional Vertigo symptomatology in elderly patients who underwent Otolith Repositioning Maneuver. There is sparse evidence from methodologically robust clinical trials that examined the effects of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises for treating Benign Paroxysmal Positional Vertigo in the elderly. Randomized controlled clinical trials with comprehensive assessment of symptoms, quality of life, function and long-term follow up are warranted.

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“…There were over three times more women than men in our series (female to male ratio, 3.19). Women are often more numerous than men in studies of BPPV [2, 26–28], perhaps because the disease is more prevalent in women [2, 29, 30], including those in the 18–34 bracket [31].…”

Section: Discussionmentioning

confidence: 99%

Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

et al. 2019

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BackgroundBenign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Little is known on how posterior canal BPPV affects health-related quality of life in patients diagnosed and treated at primary care facilities or on whether patients with subjective and objective disease perceive the effects differently. This study was designed to describe how patients diagnosed with posterior canal BPPV in primary care perceive disability.MethodsCross-sectional descriptive study performed at two urban primary care centers. Participants were patients aged 18 years or older with suspected posterior canal BPPV recruited for baseline evaluation in a clinical trial on the effectiveness of the Epley maneuver in primary care. The recruitment period was from November 2012 to January 2015. Perceived disability was evaluated using the Dizziness Handicap Inventory – Screening version (DHI-S). Other variables collected were age and sex, a history or diagnosis of anxiety or depression, treatment with antidepressants and/or anxiolytics, and results of the Dix-Hallpike (DH) test, which was considered positive when it triggered vertigo with or without nystagmus and negative when it triggered neither.ResultsThe DH test was positive in 134 patients, 40.30% of whom had objective BPPV (vertigo with nystagmus). The median age of the patients was 52 years (interquartile range [IQR], 39.00–68.50 years) and 76.1% were women. The median total score on the DHI-S was 16 out of 40 (IQR, 8.00–22.00). Scores were higher (greater perceived disability) in women (p < 0.001) and patients with subjective BPPV (vertigo without nystagmus) (p = 0.033). The items perceived as causing the greatest disability were feeling depressed (67.1%) and worsening of the condition on turning over in bed (88%).ConclusionsPatients diagnosed with posterior canal BPPV in primary care perceive their condition as a disability according to DHI-S scores, with higher levels of disability reported by women and patients with subjective BPPV. Feelings of depression and turning over in bed were associated with the greatest perceived difficulties.Trial registrationClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513

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“Positive to Negative” Dix-Hallpike test and Benign Paroxysmal Positional Vertigo recurrence in elderly undergoing Canalith Repositioning Maneuver and Vestibular Rehabilitation

Cited by 11 publications

References 42 publications

A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with pc-BPPV: A randomised controlled trial in primary care

A single Epley manoeuvre can improve self-perceptions of disability (quality of life) in patients with pc-BPPV: A randomised controlled trial in primary care

Effectiveness of Otolith Repositioning Maneuvers and Vestibular Rehabilitation exercises in elderly people with Benign Paroxysmal Positional Vertigo: a systematic review

Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

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