International Journal of Physiotherapy and Research

Home Editorial Board Author Instructions Manuscript Submission Contactus


Welcome to International Journal of Physiotherapy and Research

b2



b3

Type of Article : Original Research

Year: 2015 | Volume 3 | Issue 3 | Page No. 1059-1064

Date of Publication: 11-06-2015

DOI: 10.16965/ijpr.2015.137

ROLE OF MODIFIED EPLEY'S MANEUVER AND BRANDT-DAROFF EXERCISES IN TREATMENT OF POSTERIOR CANAL BPPV: A COMPARATIVE STUDY

Devangi S. Desai *1, Amruta S. Chauhan 2, Maharshi N. Trivedi 2.  

1* Sr. lecturer, Pioneer Physiotherapy College, Vadodara Gujarat, India.
2 Lecturer, Pioneer Physiotherapy College, Vadodara Gujarat, India.

Corresponding author: Dr. Devangi S. Desai, Sr. lecturer, Pioneer Physiotherapy College, Nr. N.H. – 8, Ajwa nimeta road, At & post. Sayajipura, Vadodara-390019, Gujarat, India.
E-Mail: devangihshah@gmail.com

Abstract:

Background: Benign paroxysmal positional vertigo (BPPV) defined by Dix and Hallpike is one of the most common disorders causing vertigo. BPPV is more prevalent in adults and in women. BPPV mostly develops in the posterior semicircular canal. The main symptom of BPPV is vertigo induced by a change in head position with respect to gravity. The Dix-Hallpike test  is the most commonly used test to confirm the diagnosis of posterior canal BPPV. Treatment options for posterior canal BPPV are Epley's maneuver, Liberatory maneuver and Brandt-Daroff exercises. In modified epley’s maneuver few modifications were done in original epley’s maneuver without affecting outcome.
Objective: To assess effectiveness of modified epley’s maneuver as well as combination of modified epley’s maneuver with Brandt-Daroff exercise in patients with posterior canal BPPV and to compare both treatment protocols.
Methodology: All patients were examined by Dix-Hallpike test (D-H Test) and those suffering from posterior canal BPPV and fulfilling inclusion criteria were taken up for the study. Total thirty five patients took part in this study on a voluntary basis after signing consent form. The patients were randomly assigned to two groups. In group 1, combination of modified epley’s maneuver and Brandt-Daroff exercise were given and in group 2 only modified epley’s maneuver was given. All patients were reexamined after 1 week of treatment and were asked to come for follow up after 1 month. In follow up visits response to Dix – Hallpike maneuver and Dizziness Handicap Inventory(DHI) were assessed as outcome measures.
Result: Data collected through this study showed highly significant improvement in DHI score and response to D-H test when intragroup comparison is made in both the groups after 1 week and 1 month of treatment at 1% level of significance. When intergroup comparison is made we found better improvement in group 2 after 1 week and in group 1 after 1 month of treatment.
Conclusion: The conclusion of the study is that both treatment approaches are effective in reducing symptoms and improving independence level  but combined approaches can give better result.
KEY WORDS: Canalith repositioning maneuver, vertigo, nystagmus, DHI, Dix-Hallpike test.

References

  1. Dix M, Hallpike CS. Pathology, symptomatology and diagnosis of certain disorders of the vestibualr system. Proc Roy Soc Med. 1952;45:341–54.
  2. Hotson JR, et al. Acute vestibular syndrome. N Engl J Med. 1998;339:680–685.
  3. Furman JM, Cass SP. Benign paroxysmal positional vertigo. N Engl J Med. 1999;341:1590–1596.
  4.  Froehling DA, et al: Benign positional vertigo: incidence and prognosis in a populationbased study in Olmsted county, Minnesota. Mayo Clin Proc 1991;66:596.
  5. Schuknecht HF. Cupulolithiasis. Arch Otolaryngol 1969;90:765.
  6. Von Brevern M, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78:710–715.
  7. Baloh RW, et al. Benign positional vertigo: clinical and oculographic features in 240 cases. Neurology. 1987;37:371–378.
  8. Hall SF, et al: The mechanism of benign paroxysmal positional vertigo. J Otolaryngol 1979;8:151.
  9. José Luis Ballve Moreno, et al. Effectiveness of the Epley’s maneuver performed in primary care to treat posterior canal BPPV: study protocol for a randomized controlled trial Trials. 2014;15:179
  10. Parnes LS, et al. Diagnosis and management of benign paroxysmal positional vertigo CMAJ. 2003;169:681–693.
  11. Moon SY, et al. Clinical characteristics of benign paroxysmal positional vertigo in Korea: a multicenter study. J Korean Med Sci. 2006;21:539–543.
  12. Blatt PJ, et al. The effect of the canalith repositioning maneuver on resolving postural instability in patients with BPPV. Am J Otol. 2000;21:356–363.
  13.  Giacomini PG, et al. Long-term postural abnormalities in benign paroxysmal positional vertigo. ORL J Otorhinolaryngol Relat Spec. 2002;64:237–241.
  14. Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional  vertigo. Otolaryngol Head Neck Surg 1992;107:399-404.
  15. Pames IS, Price-Jones RG. Particle repositioning maneuver for BPPV. Ann Ool Rhinol Laryngol 1993;102:325-31.
  16. Blakley BW. A randomized, controlled assessment of the canalith repositioning maneuver. Otolaryngol Head Neck Surg 1994;110:391-6.
  17. Yimtae K, et al. A randomized trial of the canalith repositioning procedure. Laryngoscope. 2003;113:828–832.
  18. Cohen HS, Kimball KT. Effectiveness of treatments for BPPV of the posterior canal. Otol Neurotol. 2005;26:1034–1040.
  19. Froehling DA, et al. The canalith repositioning procedure for the treatment of benign paroxysmal positional vertigo: a randomized controlled trial. Mayo Clin Proc. 2000;75:695–700.
  20. Lynn S, et al. Randomized trial of the canalith repositioning procedure. Otolaryngol Head Neck Surg. 1995;113:712–270.
  21. Helen S. Cohen, EdD, OTR and Haleh Sangi-Haghpeykar, Ph Canalith Repositioning Variations for Benign Paroxysmal Positional Vertigo Otolaryngol Head Neck Surg. Sep 2010; 143(3): 405–412.
  22. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD003162.
  23. Soto Varela A, et al. Benign paroxysmal vertigo: a comparative prospective study of the efficacy of Brandt and Daroff exercises, Semont and Epley manoeuvre. Revue de Laryngologie Otologie Rhinologie 2001;122:179–83.
  24. Cohen HS, Kimball KT. Effectiveness of treatments for BPPV of the posterior canal. Otol Neurotol. 2005;26:1034–1040.
  25. Fife TD, et al. Practice parameter: therapies for benign paroxysmal positional vertigo: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2008; 70:2067–2074.
  26. Haripriya S, et al. Comparison of Epley Maneuver and Brandt- Daroff Exercises on Short- Term Posterior Canal Benign Paroxysmal Positional Vertigo - Related Quality of Life Indian Journal of Physiotherapy and Occupational Therapy 2014, 8(3): 109-113.
  27. Amor-Dorado JC, et al. Particle repositioning maneuver versus Brandt-Daroff exercise for treatment of unilateral idiopathic BPPV of the posterior semicircular canal: a randomized prospective clinical trial with short- and long-term outcome. Otology & Neurotology 2012;33:1401–7.
  28. Helminski JO, Janssen I, Hain TC. Daily exercise does not prevent recurrence of benign paroxysmal positional vertigo. Otol Neurotol. 2008;29:976–981.
  29.  Helminski JO, Janssen I, Kotaspouikis D, et al. Strategies to prevent recurrence of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2005;131:344–438.
  30. Tanimoto H, Doi K, Katata K, Nibu K-i. Self-treatment for benign paroxysmal positional vertigo of the posterior semicircular canal. Neurology. 2005;65:1299–1300.
  31. Chang W, et al. Balance improvement in patients with benign paroxysmal positional vertigo. Clinical Rehabilitation 2008;22(4):338–47.

 

Devangi S. Desai, Amruta S. Chauhan, Maharshi N. Trivedi. ROLE OF MODIFIED EPLEY'S MANEUVER AND BRANDT-DAROFF EXERCISES IN TREATMENT OF POSTERIOR CANAL BPPV: A COMPARATIVE STUDY. Int J Physiother Res 2015;3(3):1059-1064. DOI: 10.16965/ijpr.2015.137

b2



b3




Search

Volume 1 (2013)

Volume 2 (2014)

Volume 3 (2015)

Submit Manuscript

© 2014 ijmhr.org. IJAR & IJPR. IMED Research Publications Journals