PDF herunterladen
Int Arch Otorhinolaryngol 2016; 20(04): 344-352
DOI: 10.1055/s-0036-1572528
Original Research
Thieme Publicações Ltda Rio de Janeiro, Brazil

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

Karyna M. O. B. de Figueiredo Ribeiro
1   Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
,
Lidiane Maria de Brito Macedo Ferreira
2   Post-Graduation Program in Public Health, Universidade Federal do Rio Grande do Norte, Natal, Brazil
,
Raysa Vanessa de Medeiros Freitas
1   Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
,
Camila Nicácio da Silva
1   Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
,
Nandini Deshpande
3   Faculty of Health Sciences, School of Rehabilitation Therapy, Queen's University, Kingston, Canada
,
Ricardo Oliveira Guerra
1   Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

15. September 2015

15. November 2015

Publikationsdatum:
16. Februar 2016 (online)

Auch verfügbar auf
  Lizenzen und Reprints

Abstract

Introduction Benign Paroxysmal Positional Vertigo is the most common cause of dizziness in elderly people. Recent studies have shown that the elderly present higher Benign Paroxysmal Positional Vertigo recurrence and that vertiginous symptomatology remission varies according to comorbidities and the therapeutic techniques applied.

Objective To assess the short-term effectiveness of Vestibular Rehabilitation in addition to Canalith Repositioning Maneuver on positive to negative Dix-Hallpike test, on recurrence and number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo.

Methods In this randomized controlled trial, 7 older adults (median age: 69 years, range 65–78) underwent Canalith Repositioning Maneuver and Vestibular Rehabilitation for thirteen weeks. Seven older adults (median age: 73 years, range 65–76) in the control group received only Canalith Repositioning Maneuver. The participants were assessed at baseline (T0), one (T1), five (T5), nine (T9), and thirteen weeks (T13). We assessed the differences between the groups by Mann-Whitney and Fisher exact tests, and used the Friedman and Wilcoxon tests to determine the intragroup differences.

Results No significant differences were found between groups for the positive to negative Dix-Hallpike test, recurrence, and number of maneuvers to achieve a negative test. The number of maneuvers to achieve negative Dix-Hallpike test was lower in intragroup comparisons in the experimental group.

Conclusion The findings suggest that additional Vestibular Rehabilitation did not influence the positive to negative Dix-Hallpike test, recurrence, or number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo.

Keywords

elderly - vestibular diseases - rehabilitation
 

  • References

  • 1 Maarsingh OR, Dros J, Schellevis FG, van Weert HC, Bindels PJ, Horst HE. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract 2010; 11: 2
    CrossrefSuche in Google Scholar
  • 2 Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med 2001; 134 (9 Pt 2) 823-832
    CrossrefSuche in Google Scholar
  • 3 Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?. Age Ageing 2006; 35 (2) (Suppl. 02) ii7-ii11
    CrossrefPubMedSuche in Google Scholar
  • 4 Jönsson R, Sixt E, Landahl S, Rosenhall U. Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res 2004; 14 (1) 47-52
    Suche in Google Scholar
  • 5 Kutz Jr JW. The dizzy patient. Med Clin North Am 2010; 94 (5) 989-1002
    CrossrefSuche in Google Scholar
  • 6 Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med 2000; 132 (5) 337-344
    Suche in Google Scholar
  • 7 Ganança FF, Gazzola JM, Ganança CF, Caovilla HH, Ganança MM, Cruz OL. Elderly falls associated with benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 2010; 76 (1) 113-120
    CrossrefSuche in Google Scholar
  • 8 Cho EI, White JA. Positional vertigo: as occurs across all age groups. Otolaryngol Clin North Am 2011; 44 (2) 347-360 , viii
    CrossrefPubMedSuche in Google Scholar
  • 9 Moreno NS, André AP. Number of maneuvers need to get a negative Dix-Hallpike test. Braz J Otorhinolaryngol 2009; 75 (5) 650-653
    CrossrefSuche in Google Scholar
  • 10 Caldas MA, Ganança CF, Ganança FF, Ganança MM, Caovilla HH. Clinical features of benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 2009; 75 (4) 502-506
    CrossrefSuche in Google Scholar
  • 11 De Stefano A, Dispenza F, Suarez H , et al. A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigo. Auris Nasus Larynx 2014; 41 (1) 31-36
    CrossrefPubMedSuche in Google Scholar
  • 12 Kerber KA, Burke JF, Skolarus LE , et al. Use of BPPV processes in emergency department dizziness presentations: a population-based study. Otolaryngol Head Neck Surg 2013; 148 (3) 425-430
    CrossrefPubMedSuche in Google Scholar
  • 13 Bhattacharyya N, Baugh RF, Orvidas L , et al; American Academy of Otolaryngology-Head and Neck Surgery Foundation. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2008; 139 (5) (Suppl. 04) S47-S81
    CrossrefSuche in Google Scholar
  • 14 Fife TD, Iverson DJ, Lempert T , et al; Quality Standards Subcommittee, American Academy of Neurology. Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2008; 70 (22) 2067-2074
    CrossrefPubMedSuche in Google Scholar
  • 15 Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med 2010; 152 (11) 726-732
    CrossrefPubMedSuche in Google Scholar
  • 16 Drachman DA, Hart CW. An approach to the dizzy patient. Neurology 1972; 22 (4) 323-334
    CrossrefSuche in Google Scholar
  • 17 WHO Collaborating Centre for Drug Statistics Methodology. (2012) Guidelines for ATC Classification and DDD Assignment 2013. 16th ed. WHO Collaborating Centre for Drug Statistics Methodology, Oslo.
  • 18 Flores LM, Mengue SS. Uso de medicamentos por idosos em região do sul do Brasil. Rev Saude Publica 2005; 39 (6) 924-929
    CrossrefSuche in Google Scholar
  • 19 Saúde. OMd. CID–10, tradução do Centro Colaborador da OMS para a Classificação de Doenças em Português. 2003. 9ª ed. São Paulo: EDUSP;
  • 20 Gold DR, Morris L, Kheradmand A, Schubert MC. Repositioning maneuvers for benign paroxysmal positional vertigo. Curr Treat Options Neurol 2014; 16 (8) 307
    CrossrefPubMedSuche in Google Scholar
  • 21 Silva AL, Marinho MR, Gouveia FM, Silva JG, Ferreira AdeS, Cal R. Benign Paroxysmal Positional Vertigo: comparison of two recent international guidelines. Braz J Otorhinolaryngol 2011; 77 (2) 191-200
    CrossrefSuche in Google Scholar
  • 22 Helminski JO, Zee DS, Janssen I, Hain TC. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther 2010; 90 (5) 663-678
    CrossrefSuche in Google Scholar
  • 23 Angeli SI, Hawley R, Gomez O. Systematic approach to benign paroxysmal positional vertigo in the elderly. Otolaryngol Head Neck Surg 2003; 128 (5) 719-725
    CrossrefSuche in Google Scholar
  • 24 Herdman SJ, Tusa RJ. Physical Therapy Management of Benign Positional Vertigo. In: Herdman SJ. Vestibular Rehabilitation. 3rd ed. Philadelphia, PA: F. A. Davis Company; 2007: 233-60
    Suche in Google Scholar
  • 25 Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992; 107 (3) 399-404
    CrossrefSuche in Google Scholar
  • 26 Bruintjes TD, Companjen J, van der Zaag-Loonen HJ, van Benthem PP. A randomised sham-controlled trial to assess the long-term effect of the Epley manoeuvre for treatment of posterior canal benign paroxysmal positional vertigo. Clin Otolaryngol 2014; 39 (1) 39-44
    CrossrefSuche in Google Scholar
  • 27 Alsalaheen BA, Whitney SL, Mucha A, Morris LO, Furman JM, Sparto PJ. Exercise prescription patterns in patients treated with vestibular rehabilitation after concussion. Physiother Res Int 2013; 18 (2) 100-108
    CrossrefPubMedSuche in Google Scholar
  • 28 Chang WC, Yang YR, Hsu LC, Chern CM, Wang RY. Balance improvement in patients with benign paroxysmal positional vertigo. Clin Rehabil 2008; 22 (4) 338-347
    CrossrefSuche in Google Scholar
  • 29 Herdman SJ, Whitney SL. Interventions for the Patient with Vestibular Hypofunction. In: Herdman SJ. Vestibular Rehabilitation. 3rd ed. Philadelphia, P.A.: f.a. Davis Company; 2007: 3009–37Herdman SJ WS. Interventions for the patient with Vestibular Hypofunction. 2007: 309-37
    Suche in Google Scholar
  • 30 Alrwaily M, Whitney SL. Vestibular rehabilitation of older adults with dizziness. Otolaryngol Clin North Am 2011; 44 (2) 473-496 , x
    CrossrefSuche in Google Scholar
  • 31 Gazzola JM, Ganança FF, Aratani MC, Perracini MR, Ganança MM. Circumstances and consequences of falls in elderly people with vestibular disorder. Braz J Otorhinolaryngol 2006; 72 (3) 388-392
    CrossrefSuche in Google Scholar
  • 32 Liao WL, Chang TP, Chen HJ, Kao CH. Benign paroxysmal positional vertigo is associated with an increased risk of fracture: a population-based cohort study. J Orthop Sports Phys Ther 2015; 45 (5) 406-412
    CrossrefSuche in Google Scholar
  • 33 Whitney SL, Sparto PJ. Principles of vestibular physical therapy rehabilitation. NeuroRehabilitation 2011; 29 (2) 157-166
    Suche in Google Scholar
  • 34 Dorigueto RS, Mazzetti KR, Gabilan YP, Ganança FF. Benign paroxysmal positional vertigo recurrence and persistence. Braz J Otorhinolaryngol 2009; 75 (4) 565-572
    CrossrefSuche in Google Scholar
  • 35 Kao CL, Hsieh WL, Chern CM, Chen LK, Lin MH, Chan RC. Clinical features of benign paroxysmal positional vertigo (BPPV) in Taiwan: differences between young and senior age groups. Arch Gerontol Geriatr 2009; ; 49 (2) (Suppl. 02) S50-S54
    CrossrefPubMedSuche in Google Scholar
  • 36 Baloh RW, Honrubia V, Jacobson K. Benign positional vertigo: clinical and oculographic features in 240 cases. Neurology 1987; 37 (3) 371-378
    CrossrefSuche in Google Scholar
  • 37 Brandt T, Daroff RB. Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 1980; 106 (8) 484-485
    CrossrefSuche in Google Scholar
  • 38 Choi SJ, Lee JB, Lim HJ , et al. Clinical features of recurrent or persistent benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2012; 147 (5) 919-924
    CrossrefSuche in Google Scholar
  • 39 Batuecas-Caletrio A, Trinidad-Ruiz G, Zschaeck C , et al. Benign paroxysmal positional vertigo in the elderly. Gerontology 2013; 59 (5) 408-412
    CrossrefSuche in Google Scholar
  • 40 Charles C, Santina D, Minor LB, Carey JP, In: Lee KJ. Princípios de Otorrinolaringologia: cirurgia de cabeça e pescoço. 9th ed. Porto Alegre, RS: AMGH editora; 2010: 94-134
    Suche in Google Scholar
  • 41 Tanimoto H, Doi K, Nishikawa T, Nibu K. Risk factors for recurrence of benign paroxysmal positional vertigo. J Otolaryngol Head Neck Surg 2008; 37 (6) 832-835
    Suche in Google Scholar
  • 42 De Reuck J. Vascular risk factors in patients with peripheral vestibular disorders. Acta Neurol Belg 2010; 110 (4) 303-305
    Suche in Google Scholar
  • 43 Wada M, Naganuma H, Tokumasu K, Hashimoto S, Ito A, Okamoto M. Arteriosclerotic changes as background factors in patients with peripheral vestibular disorders. Int Tinnitus J 2008; 14 (2) 131-134
    Suche in Google Scholar
  • 44 Kao CL, Cheng YY, Leu HB , et al. Increased risk of ischemic stroke in patients with benign paroxysmal positional vertigo: a 9-year follow-up nationwide population study in taiwan. Front Aging Neurosci 2014; 6 (2) 108
    Suche in Google Scholar
  • 45 Gazzola JM, Ganança FF, Aratani MC, Perracini MR, Ganança MM. Clinical evaluation of elderly people with chronic vestibular disorder. Braz J Otorhinolaryngol 2006; 72 (4) 515-522
    CrossrefSuche in Google Scholar
  • 46 Bittar RS, Pedalini ME, Ramalho JO, Yoshimura R. Critical analysis of vestibular rehabilitation outcome according to dizziness etiology. Braz J Otorhinolaryngol 2007; 73 (6) 760-764
    CrossrefSuche in Google Scholar
  • 47 Yu S, Liu F, Cheng Z, Wang Q. Association between osteoporosis and benign paroxysmal positional vertigo: a systematic review. BMC Neurol 2014; 14: 110
    CrossrefPubMedSuche in Google Scholar
  • 48 Gassmann KG, Rupprecht R. Dizziness in an older community dwelling population: a multifactorial syndrome. J Nutr Health Aging 2009; 13 (3) 278-282
    CrossrefSuche in Google Scholar
  • 49 Gomez F, Curcio CL, Duque G. Dizziness as a geriatric condition among rural community-dwelling older adults. J Nutr Health Aging 2011; 15 (6) 490-497
    CrossrefSuche in Google Scholar