Role of Postural Stability exercises in management of Benign Paroxysmal Positional Vertigo

Benignparoxysmal positional vertigo (BPPV) is a mechanical problem of peripheralvestibular system resulting from otoconia being displaced into the semicircularcanals or otoconia being adhered to the cupulla ampullaris.

It represents the mostcommon etiology of vertigo and 1% of all patient visits to a physician. It comprises18.75% of total patients coming to outdoor department with complaint of vertigodue to various reasons in Gujarat.

Characterized by briefepisodes of vertigo, with perception of either the environment or one’s selfspinning when the head is moved in certain position.

Patients report thatvertigo is triggered by lying down, rolling over in bed, getting out of the bed, bendingdown or looking upward.

It is the mostcommon cause of recurrent and episodic vertigo from peripheral vestibular disorder.

Otherassociated complaints include problems in balance that may last for hours ordays after the episode of vertigo has stopped and more vague sensation oflightheadedness or feeling of floating.

Spontaneous remission ofthis condition is common. For those whomepisodic vertigo persists, this disorder can be annoying, disruptive and oftenresults in significant changes in normal activities.

There are goodevidences of the particle repositioning maneuvers being very effective inresolving the symptoms of BPPV. Epley’s maneuver for canaliathiasis and Semont’s or Liberatory maneuver for cupulolithiasis are effectivein diminishing vertigo and Brandt-Daroff exercises as habituation exercise forless symptomatic patients.

After BPPV hasbeen successfully treated and spinning symptoms resolved, some patients willcontinue to report non-specific dizziness (symptoms other than spinning) and/orimbalance.

BPPV representedthe most prevalent diagnosis on the population studied (43.8%) as most commonreason of falls.

Most of thestudies have examined the effectiveness of one or more maneuver or compared thevarious maneuver along with the rates of emission as an outcome measures.

There seems to beinsufficient scientific evidence on effect postural stability exercises orvestibular rehabilitation as a whole in cases of BPPV .

Hence the aims and objectives of this study are as follows:

1.To assessbalance in patients of BPPV.

2.To evaluate shortterm and long term effects of adding postural stability exercises to particlerepositioning maneuver in patients of BPPV.

3.To assess thecorrelation between the outcome measures of the study i.e. m- CTSIB, m-DGI andDHI in patients of BPPV