Effects of Vestibular Rehabilitation Program on Dizziness, Vertigo and Balance in Population With Vertigo
Condition: Vertigo
MeSH terms: Vertigo; Dizziness
Study type: Interventional

Summary: 
      Benign Paroxysmal Positional Vertigo (BPPV) is characterized by short, recurrent and intense
      episodes of vertigo. Repositioning maneuvers have been used for its treatment however,
      evidence indicated recurrence with these maneuvers. However, the effectiveness of this
      intervention for improving dynamic and static balance in patients with BPPV is unknown.
      Vestibular rehabilitation through Caw-throne and Cooksey exercises improves dizziness,
      balance and gives postural stability. This study aims to determine effects of these exercises
      in improving the residual symptoms of dizziness and balance impairments after CRM. This
      randomized controlled trial will recruit patients through convenience sampling. Diagnosed
      patients of BPPV will be confirmed for inclusion through Dix-Hallpike test. Patients
      presenting with other neurological, orthopedic or metabolic conditions, patients who have had
      exposure to any balance exercises or other forms of training that can influence results will
      also be excluded to limit confounding factors A sample of 26 patients will be taken and
      divided into two groups each with 13 patients. Group A will receive conventional physical
      therapy while group B will receive Vestibular Rehabilitation exercises with the conventional
      physical therapy protocol. The conventional physical therapy protocol will include Cervical
      stretches and Basic Balance Exercises. The session will be around 40 min on each patient with
      three session per week on alternate days.The study will evaluate patients through Vertigo
      symptom Scale (to identify vertigo), Dizziness Handicap Inventory (to identify
      dizziness),Berg Balance Scale (to identify balance and risk of fall). The data will be
      analyzed using SPPS software.
    

Detailed description: 
      Vertigo is the perception of motion, which may be described as a sensation of swaying,
      tilting, spinning of environment or feeling unbalanced. Due to highly variable descriptions
      of vertigo, it is often consolidated into the umbrella descriptor 'dizziness', a very common
      complaint.Vertigo can be of vestibular or peripheral origin or be due to non-vestibular or
      central causes. Benign paroxysmal positional vertigo (BPPV) is the most common cause of
      peripheral vertigo, accounting for over half of all cases. One of the treatment options for
      vestibular disorders (unilateral and bilateral vestibular hypofunction and central or mixed
      vestibular disorders) is vestibular rehabilitation (VR). This consists of an individualized
      exercise program which has been developed to address the deficits identified during the
      physical therapy evaluation and which has been shown to be an effective treatment for
      patients with dizziness and balance disorders. Currently, this program includes compensatory
      responses, adaptation for visual-vestibular interaction, substitution and postural control
      exercises, fall prevention, (re)conditioning activities, and functional retraining.These
      exercises have been used alone or in conjunction with other vestibular approaches and have
      been proved effective in improving balance and decreasing fall risk (stroke), postural
      stability (healthy adults), balance (multiple sclerosis) and decreasing perception of
      disability (unilateral vestibular hypofunction). Their effectiveness on vertigo, dizziness
      and balance in patients with BPPV has limited evidence. The current study is designed to
      determine the effects of Vestibular Rehabilitation exercises on vertigo, dizziness and
      balance in patients with BPPV. The purpose of this study is that, it will provide the
      evidence which might improve the treatment strategies for the management of symptoms of BPPV
      and their recurrence after Canalith Repositioning Maneuver and improve the quality of life.
    

Intervention name(s): Cawthrone and cooksey exercises,Epley's repositioning maneuver will be performed also cervical stretches with basic balance exercises.; Epley's repositioning maneuver will be performed also cervical stretches with basic balance exercises.
Intervention type(s): Other; Other
Intervention description(s): Epley "repositioning maneuver will be performed, also cervical stretches and Basic Balance exercises Following Exercises will be performed by patient in next session. Caw-Thorne and Cooksey exercise program. Participants will receive CRM for 6 weeks as needed in each evaluation. Frequency: These exercises will be performed thrice a week on alternate days for 40 min sessions. Post-Intervention Assessment: The patients will be assessed 6 weeks after the beginning of the intervention; Conventional treatment: Epley's repositioning maneuver will be performed also cervical stretches with basic balance exercises.
Frequency: Participants will receive CRM for 6 weeks as needed in each evaluation. Frequency: These exercises will be performed thrice a week on alternate days for 40 min sessions. Post-Intervention Assessment: The patients will be assessed 6 weeks after the beginning of the intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Rehabilitation exercises; Vertigo; Balance