Effectiveness of otolith repositioning maneuvers and vestibular rehabilitation exercises in elderly people with benign paroxysmal positional vertigo: a systematic review.

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Effectiveness of otolith repositioning maneuvers and vestibular rehabilitation exercises in elderly people with benign paroxysmal positional vertigo: a systematic review.

Braz J Otorhinolaryngol. 2017 Jun 29;:

Authors: Ribeiro KF, Oliveira BS, Freitas RV, Ferreira LM, Deshpande N, Guerra RO

Abstract
INTRODUCTION: Benign Paroxysmal Positional Vertigo (BPPV) is highly prevalent in elderly people. This condition is related to vertigo, hearing loss, tinnitus, poor balance, gait disturbance, and an increase in risk of falls, leading to postural changes and quality of life decreasing.
OBJECTIVE: To evaluate the outcomes obtained by clinical trials on the effectiveness of Otolith Repositioning Maneuver (ORM) and Vestibular Rehabilitation (VR) exercises in the treatment of BPPV in elderly.
METHODS: The literature research was performed using PubMed, Scopus, Web of Science and PEDro databases, and included randomized controlled clinical trials in English, Spanish and Portuguese, published during January 2000 to August 2016. The methodological quality of the studies was assessed by PEDro score and the outcomes analysis was done by critical revision of content.
RESULTS: Six studies were fully reviewed. The average age of participants ranged between 67.2 and 74.5 years. Three articles were not assessed by PEDro score and the remaining received low classification varying from 2 to 7/10. The main outcome measures analyzed were vertigo, positional nystagmus and postural balance. Additionally, the number of maneuvers necessary for remission of the symptoms, the quality of life, and the functionality were also assessed. The majority of the clinical trials used ORM (n=5) and 3 articles performed VR exercises in addition to ORM or pharmacotherapy. One study showed that the addition of movement restrictions after maneuver did not influence the outcomes.
CONCLUSION: There was a trend of improvement in BPPV symptomatology in elderly patients who underwent ORM. There is sparse evidence from methodologically robust clinical trials that examined the effects of ORM and VR exercises for treating BPPV in the elderly. Randomized controlled clinical trials with comprehensive assessment of symptoms, quality of life, function and long-term follow up are warranted.

PMID: 28716503 [PubMed - as supplied by publisher]

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