Exercise treatment for paroxysmal positional vertigo: comparison of two types of exercises

The use of exercises can be an excellent method for treating benign paroxysmal positional vertigo (BPPV). We compared the results obtained by a progressive training method, vestibular habituation training (VHT), with a brisk exercise method. While VHT can be applied in all kinds of "provoked" (positional) vertigo of peripheral origin, the brisk method can be used only in typical BPPV, provided the vertigo is unilaterally provoked. A series of patients with such typical "unilateral" cases were treated by the brisk method and were compared with a second series of identical cases treated by the VHT technique. The results after 1 week seemed to be different: with the brisk method 52% of the patients were free of vertigo, while only 32% with VHT were vertigo free. This difference is not statistically significant. However, those cases treated by VHT and still having vertigo after 1 week had a striking reduction in the severity of their vertigo, as estimated by the score-system used. In contrast, the scores were unchanged for those cases not responding to the brisk method. Continuation of treatment of these latter cases using VHT exercises showed that the final result after 6 weeks was equal for both groups.