Helminski J, Janssen I, Kotaspouikis D, Hain T; Midwestern University, Downers Grove, IL and Northwestern University, Chicago, IL. jhelmi@midwestern.edu.

PURPOSE: The purpose of this study was to determine if following successful treatment of Benign Paroxsymal Positional Vertigo involving the posterior semicircular canal (BPPV–PC), a daily routine of Brandt-Daroff exercises will increase the time to and reduce the rate of recurrence of BPPV. BPPV–PC is treated effectively with the canalith repositioning procedure (Epley, 1992), the average success rate being 76% (Harvey, Hain, and Adamiec, 1994). Of patients successfully treated, 44% redevelop BPPV within 2 years (Hain, Helminski, Reis and Uddin, 2000). SUBJECTS: We identified 112 subjects with BPPV-PC, treated successfully with the canalith repositioning procedure. METHODS: Patients were assigned to the no-treatment group (n = 83) and the treatment group (n = 29). Between the no-treatment and treatment group, there was no significant difference in age, gender, duration of symptoms, etiology, and history of recurrent BPPV. The treatment group performed 2 cycles of the Brandt-Daroff exercises daily. Subjects were followed for up to 2 years. If vertigo recurred, subjects were reevaluated in the clinic with the Dix-Hallpike maneuver. ANALYSIS: Of the 112 subjects, symptoms recurred overall in 39% (n = 44), in 42% of the no-treatment group (n = 33/73) and in 29% of the treatment group (n = 11/38). The difference in frequency of recurrence between the 2 groups was not significant (Pearson c ², p = 0.097). However, there was a positive trend that daily exercises reduced the frequency of recurrence. There was no significant difference in the time to recurrence between the 2 groups (survival analysis, log-rank test, p = 0.628). We also examined whether history of recurrent BPPV-PC significantly affected the frequency of recurrence of BPPV between the no-treatment and treatment groups. Of the 112 subjects, 107 subjects were analyzed. BPPV recurred in 19% (n = 4/21) of the treatment group with no history of recurrence, 41%(n = 7/17) of the treatment group with a history of recurrence, 39%(n = 17/44) of the no-treatment group with no history, and 52%(n = 13/25) of the no-treatment group with a history. The differences (Pearson c ², P = 0.149) and observed trend (Cochran’s test for linear trend, p = 0.035) were significant between the groups. There was no difference in the time to recurrence between the groups (survival analysis, log-rank test, p = 0.534). CONCLUSIONS: Our results suggest that a daily routine of Brandt-Daroff exercises reduces the rate of recurrence of BPPV for patients with no history of BPPV and has no effect for patients with a history of recurrent BPPV. A daily routine of Brandt-Daroff exercises does not affect the time to recurrence of BPPV. FUNDING SOURCE: National Institute of Health, National Institute on Aging, 1 R15 AG17567-01A1.

Copyright 2004 by the American Physical Therapy Association

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