Oculomotor and Vestibular Ocular Reflex Exercises in Patients With Benign Paroxysmal Positional Vertigo

Not Applicable

Completed

Interventions: Other: Oculomotor and Vestibular Ocular Reflex (VOR) exercises
Other: Traditional physical therapy using Epley's maneuver

Brief Summary: The aim of this research is to assess effects of Oculomotor and VOR exercises on vertigo, dizziness and balance in patients with BPPV. Randomized controlled trial was conducted at Hameed Latif Hospital, Lahore. The sample size 32 participants which were divided into two groups, 16 participants in traditional physical therapy group and 16 in oculomotor and vestibular ocular reflex exercises group. Study duration was of 6 months. Sampling technique applied was non-probability consecutive sampling technique. Only 30-70 years individuals with Benign Paroxysmal Positional Vertigo (BPPV) were included. Tools used in the study are vertigo handicap questionnaire, visual vertigo analogue scale, dizziness handicap inventory, berg balance scale and dynamic gait index. The data was analyzed using SPSS.

Detailed Description: Randomized controlled trial was conducted at Hameed Latif Hospital, Lahore. The sample size 32 participants which were divided into two groups, 16 participants in traditional physical therapy group and 16 in oculomotor and vestibular ocular reflex exercises group. Study duration was of 6 months. Sampling technique applied was non-probability consecutive sampling technique. Only 30-70 years individuals with Benign Paroxysmal Positional Vertigo (BPPV) were included. Tools used in the study are vertigo handicap questionnaire, visual vertigo analogue scale, dizziness handicap inventory, berg balance scale and dynamic gait index. The data was analyzed using SPSS.

Recruitment & Eligibility

Inclusion Criteria

Patients who have vertigo with posterior canal involvement during Dix-Hallpike test with or without accompanying nystagmus (objective or subjective BPPV).
Ability to walk at least 3 meters by itself with or without assistive device
Normal vision with or without correction by spectacles or contact lenses

Exclusion Criteria

Patients with other neurologic conditions, orthopedic problems, and uncontrolled metabolic diseases to eliminate confounding factors affecting balance performance
Unable to understand and answer a simple verbal command.
Previously underwent oculomotor and vestibular ocular exercises.
Other vestibular disorders like Meniere disease
Long-term use of benzodiazepines (more than 20 years).
Patients who are already performing structured physical activities such as muscle strengthening exercises, Pilates, yoga or high intensity aerobic exercises

Arm && Interventions

Group	Intervention	Description
Oculomotor and Vestibular Ocular Reflex (VOR) exercises	Oculomotor and Vestibular Ocular Reflex (VOR) exercises	oculomotor and VOR exercises after Epley's maneuver. The exercises were performed for approximately 5 minutes daily or 1 to 2 minutes, 3 to 4 times a day, in sitting position. The exercises were continued for three weeks. The maneuver was performed by patient in sitting position, head was rotated towards involved side and then extended to 30 degrees, it was then rotated to 180 degrees followed by patient rolling onto opposite side. Each position was maintained for 1-2 minutes. Saccadic exercises were performed by moving eyes between two stationary targets. Smooth pursuit exercises were performed by tracking a moving target while keeping head still and VOR exercises were performed by moving head left to right while maintaining eyes on stationary target
Traditional physical therapy using Epley's maneuver	Traditional physical therapy using Epley's maneuver	Epley's maneuver was performed once a week for three weeks. The maneuver was performed by patient in sitting position, head was rotated towards involved side and then extended to 30 degrees, it was then rotated to 180 degrees followed by patient rolling onto opposite side. Each position was maintained for 1-2 minutes.

Primary Outcome Measures

Name	Time	Method
Visual Vertigo Analogue Scale	second reading after 3 weeks	Intensity of visual vertigo in nine challenging situations of visual motions that typically provoke dizziness
Dizziness Handicap Inventory	second reading after 3 weeks	Self-perceived handicapping effects imposed by dizziness.
Berg Balance Scale	First reading at 3 week	Objectively determine a patient's ability (or inability) to safely balance during a series of predetermined tasks
Vertigo Handicap Questionnaire	second reading after 3 weeks	It assess effect of vertigo on disability, handicap and benefits following therapeutic intervention both physically and psychologically.
Dynamic Gait Index	second reading after 3 weeks	The clinical tool to assess gait, balance and fall risk. It evaluates not only usual steady-state walking, but also walking during more challenging tasks.

Secondary Outcome Measures

Name	Time	Method