TY - JOUR

T1 - Reposition Chair Treatment Improves Subjective Outcomes in Refractory Benign Paroxysmal Positional Vertigo

AU - West, Niels

AU - Bloch, Sune Land

AU - Moller, Martin Nue

AU - Hansen, Soren

AU - Klokker, Mads

PY - 2019

Y1 - 2019

N2 - OBJECTIVES: Despite increasing utilization of reposition devices in the management of benign paroxysmal positional vertigo (BPPV), knowledge on subjective outcomes is insufficient. The objective of the present study was to evaluate subjective vertigo complaints and vertigo-associated emotional distress during reposition chair management for refractory BPPV.MATERIALS AND METHODS: This was a prospective observational cohort study of subjective and objective data of 31 patients suffering from refractory BPPV representing failed conventional repositioning treatment. At the beginning of each visit, the patients filled out the Dizziness Handicap Inventory (DHI), the Visual Analog Scale (VAS), and the Hospital Anxiety and Depression Scale (HADS). Treatment and re-evaluation were repeated every 2 weeks until the patient was declared disease-free.RESULTS: Complete remission of BPPV required a mean of two treatments. Mean DHI score decreased from 45 points prior to first treatment to 22 points by finished treatment (p<0.001). Similarly, mean VAS score was reduced from 58 to 25 points (p<0.001), and HADS decreased from 8 to 5 points (p<0.001). Patients with cupulolithiasis reported worse vertigo complaints than those with canalolithiasis. All scores correlated positively.CONCLUSION: Patients with refractory BPPV improved significantly by reposition chair management according to all subjective outcomes. Thus, the reposition device could significantly reduce disease burden in the group of patients with BPPV who failed to respond to conventional management. The strong correlation between the scores suggests VAS as a useful tool for vertigo-related patient complaints.

AB - OBJECTIVES: Despite increasing utilization of reposition devices in the management of benign paroxysmal positional vertigo (BPPV), knowledge on subjective outcomes is insufficient. The objective of the present study was to evaluate subjective vertigo complaints and vertigo-associated emotional distress during reposition chair management for refractory BPPV.MATERIALS AND METHODS: This was a prospective observational cohort study of subjective and objective data of 31 patients suffering from refractory BPPV representing failed conventional repositioning treatment. At the beginning of each visit, the patients filled out the Dizziness Handicap Inventory (DHI), the Visual Analog Scale (VAS), and the Hospital Anxiety and Depression Scale (HADS). Treatment and re-evaluation were repeated every 2 weeks until the patient was declared disease-free.RESULTS: Complete remission of BPPV required a mean of two treatments. Mean DHI score decreased from 45 points prior to first treatment to 22 points by finished treatment (p<0.001). Similarly, mean VAS score was reduced from 58 to 25 points (p<0.001), and HADS decreased from 8 to 5 points (p<0.001). Patients with cupulolithiasis reported worse vertigo complaints than those with canalolithiasis. All scores correlated positively.CONCLUSION: Patients with refractory BPPV improved significantly by reposition chair management according to all subjective outcomes. Thus, the reposition device could significantly reduce disease burden in the group of patients with BPPV who failed to respond to conventional management. The strong correlation between the scores suggests VAS as a useful tool for vertigo-related patient complaints.

KW - Adult

KW - Aged

KW - Anxiety/etiology

KW - Benign Paroxysmal Positional Vertigo/diagnosis

KW - Cohort Studies

KW - Dizziness/physiopathology

KW - Female

KW - Head Movements/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Nystagmus, Pathologic/complications

KW - Nystagmus, Physiologic

KW - Patient Positioning/instrumentation

KW - Physical Therapy Modalities

KW - Prospective Studies

KW - Semicircular Canals/pathology

KW - Vertigo/complications

KW - Visual Analog Scale

U2 - 10.5152/iao.2019.5659

DO - 10.5152/iao.2019.5659

M3 - Journal article

C2 - 31058604

VL - 15

SP - 146

EP - 150

JO - Mediterranean Journal of Otology

JF - Mediterranean Journal of Otology

SN - 1308-7649

IS - 1

ER -