Postural control in older patients with benign paroxysmal positional vertigo

Area of Science:

• Neurology
• Geriatrics
• Vestibular Rehabilitation

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness in older adults, significantly impacting their postural control and quality of life.
• Idiopathic BPPV in the elderly presents unique challenges for management and rehabilitation.

Purpose of the Study:

• To assess the efficacy of a canalith-repositioning procedure (CRP) in improving postural control among elderly patients diagnosed with idiopathic BPPV.
• To evaluate the impact of CRP on subjective dizziness and objective balance parameters.

Main Methods:

• A prospective clinical trial involving 33 older patients with BPPV at a tertiary referral center.
• Static posturography (Balance Rehabilitation Unit [BRU]) and the Dizziness Handicap Inventory (DHI) were administered before and after CRP.
• Postural parameters including limit of stability (LOS), center of body-pressure area (COP), and velocity of oscillation (VOS) were measured under various sensory conditions.

Main Results:

• A single CRP maneuver resolved symptoms in 54.5% of patients, with 100% symptom relief after 1-3 maneuvers.
• Significant improvements were observed in total DHI scores and all subscales post-treatment (P < .01).
• Post-treatment LOS, COP, and VOS values showed significant improvements, with treated patients demonstrating comparable VOS and COP values to healthy older adults in most conditions.

Conclusions:

• The canalith-repositioning procedure is highly effective in achieving symptom remission for BPPV in older adults.
• CRP significantly enhances postural control, particularly under somatosensory and visual-vestibular conflict conditions.
• The procedure leads to improved balance and a reduction in dizziness handicap, restoring functional stability.