Effects of balance Vestibular Rehabilitation Therapy in elderly with Benign Paroxysmal Positional Vertigo: a randomized controlled trial

Abstract

Purpose: To evaluate short-term effects of balance Vestibular Rehabilitation Therapy (VRT) on balance, dizziness symptoms and quality of life of the elderly with chronic Benign Paroxysmal Positional Vertigo (BPPV).

Method: In this randomized, single-blind and controlled trial, older adults with chronic BPPV were randomized into two groups, the experimental group (n = 7, age: 69 (65–78) years) and the control group (n = 7, age: 73 (65–76) years). Patients in the experimental group underwent balance VRT (50 min per session, two times a week) and Canalith Repositioning Maneuver (CRM) as required, for 13 weeks. The control group was treated using only CRM as required. Standing and dynamic balance, dizziness symptoms and quality of life were measured at the baseline, and at one, five, nine and thirteen weeks.

Results: There were no between-group differences in dizziness, quality of life and standing balance over the 13 weeks. Significant differences were observed in dynamic balance measures between groups (p <  0.05 for most tests) through assessments. In intragroup analysis, both groups showed improvements in all measurements except no improvement was found in majority of the dynamic balance tests in the control group.

Conclusions: The patients who received additional balance VRT demonstrated better results in dynamic balance than those who received only CRM.

Implications for Rehabilitation

• The findings that balance VRT in addition to CRM improves dynamic balance in elderly people with BPPV should be useful in guiding rehabilitation professionals’ clinical decision making to design interventions for seniors suffering from BPPV;

• Improvements in tests of dynamic balance suggest that the risk of adverse consequences of BPPV in the elderly such as falls and fractures can be potentially reduced through implementation of CRM in conjunction with balance VRT;

• Lack of additional improvement in Visual Analogue Scale of dizziness and Dizziness Handicap Index suggests that addition of balance VRT does not influence dizziness symptomatology, per se, and CRM alone is effective to ameliorate vertiginous symptoms and potentially improve quality of life.

Keywords:

• Aged
• Benign paroxysmal positional vertigo
• dizziness
• postural balance
• rehabilitation

Acknowledgements

We thank Dr. Susan L. Whitney from University of Pittsburgh (USA) for her guidance on the study design and Dr. Álvaro C. Maciel from Federal University of Rio Grande do Norte (Brazil) for his assistance on the study data analysis.

Disclosure statement

The authors report no conflicts of interest.