Investigation of the kinematics and proprioception in patients with benign paroxysmal positional vertigo compared to...

This study aimed to investigate changes in cervical kinematics and proprioception in patients with history of recurrent idiopathic posterior canal benign paroxysmal positional vertigo (BPPV) compared to healthy controls.

This was a cross-sectional study comparing patients with BPPV (cases) to healthy controls that was done at Orthopedic and Rehabilitation Research Center. Twenty-five patients with idiopathic posterior canal BPPV (41.08 ± 8.89 years) and 27 age-matched healthy controls (37.37 ± 7.31 years). Posterior canal BPPV confirmed by Dix-Hallpike maneuver, in subjects who last more than two weeks since the last of their vertigo episode, with Tampa Scale for Kinesiophobia (TSK) score < 37. Cervical kinematics (range of motion) were measured using synchronized electrogoniometer systems, while proprioception was assessed via laser-based joint position error testing. Data were analyzed using independent t-tests (normal distribution) and Mann-Whitney U tests (non-parametric data), with significance at p < 0.05.

Twenty-five BPPV patients and 27 controls completed the study. BPPV patients had significantly lower maximum neck extension (28.32°±19.44° vs. 46.52°±23.05°, p = 0.004), flexion (21.01°±7.9° vs. 30.05°±9.12°, p < 0.0001), lateral bending to left (22.62°±6.27° vs. 32.22°±10.6°, p < 0.0001) and right (23.36°±8.31° vs. 29.66°±10.55°, p = 0.023). No significant differences were observed in rotation ROM (p > 0.05). Joint position error was significantly higher in the BPPV group for all directions (flexion, extension, right/left rotation; p < 0.0001).Furthermore, peak movement velocity was reduced in the BPPV group in the sagittal (16 ± 8 deg/s vs. 26 ± 11 deg/s, p < 0.0001) and frontal planes (17 ± 6 deg/s vs. 24 ± 7 deg/s, p = 0.001).

It seems that patients with BPPV would have greater kinematic and proprioceptive deficits. These findings highlight a significant association between cervical musculoskeletal dysfunction and BPPV. The cross-sectional nature of this study cannot determine causality; therefore, future longitudinal or cohort studies are essential to investigate the temporal and potential causative relationship between these variables.