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Using Unidirectional Rotations to Improve Vestibular System Asymmetry in Patients with Vestibular Dysfunction

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Routine benign paroxysmal positional vertigo (BPPV) physiotherapy management: a feasibility study.

Erin Dale Bicknell¹, Laura Ferguson¹, Alisha da Silva¹

¹The Royal Melbourne Hospital-Physiotherapy Department, Parkville, Victoria, Australia.

|March 18, 2025

Summary

This summary is machine-generated.

Routine physiotherapy for benign paroxysmal positional vertigo (BPPV) in older subacute inpatients was not feasible due to physical and cognitive limitations. While physiotherapists found BPPV management important, patient factors and clinical priorities posed challenges.

Keywords:

benign paroxysmal positional vertigo (BPPV)falls inpatient older adults older people subacute

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Area of Science:

Geriatric Medicine
Physical Therapy
Neurology

Background:

Benign paroxysmal positional vertigo (BPPV) is a prevalent condition among older adults, particularly those with a history of falls.
The feasibility of integrating routine physiotherapy for BPPV management into subacute inpatient care for this demographic remains largely unexplored.

Purpose of the Study:

To assess the feasibility of implementing routine physiotherapy for BPPV in older subacute inpatients.
To determine the prevalence of BPPV in this patient population.

Main Methods:

Subacute inpatients aged 50 years or older with a recent fall history were evaluated for BPPV.
Feasibility was defined as assessing over 75% of eligible patients.
Physiotherapist perceptions, patient demographics, medical history, frailty, functional mobility, and modified Dizziness Handicap Inventory (DHI) scores were collected.

Main Results:

Only 67% of eligible patients (447) underwent BPPV assessment, with physical limitations and cognitive impairment being primary barriers.
Physiotherapists deemed BPPV management acceptable (88%), appropriate (90%), and feasible (76%), but noted constraints from patient factors, time, and environment.
BPPV was diagnosed in 6% of assessed patients; 35% reported current dizziness. Higher modified DHI scores were associated with positive BPPV findings.

Conclusions:

Routine BPPV physiotherapy management was not feasible in this subacute inpatient cohort due to significant physical and cognitive impairments.
Physiotherapists recognize the importance of BPPV management but face challenges due to patient-specific issues and competing clinical demands.
The 5-item Dizziness Handicap Inventory (DHI) may help identify patients requiring individualized BPPV assessment, as subjective symptoms alone may not reliably indicate BPPV presence.