Habituation Exercises Versus Proprioceptive Training in Benign Paroxysmal Positional Vertigo
Condition: Benign Paroxysmal Positional Vertigo
MeSH terms: Vertigo; Benign Paroxysmal Positional Vertigo; Dizziness
Study type: Interventional

Summary: 
      The aim of this research is to compare the effects of habituation exercises versus
      proprioceptive training on vertigo, balance, dizziness and quality of life in the individuals
      having benign paroxysmal positional vertigo. A randomized controlled trial that will include
      total 39 participants .The first group will receive habituation exercises for six weeks,
      three times per week for thirty minutes, along with conventional vestibular rehabilitation
      therapy. The second group will receive proprioceptive training for six weeks, three times per
      week for 30 minutes, along with vestibular rehabilitation therapy. The third group will only
      receive vestibular rehabilitation therapy. Data collected will be analyzed through SPSS 25.
    

Detailed description: 
      Benign paroxysmal positional vertigo is the most common presentation of peripheral vestibular
      disorder characterized by features like vertigo, nausea, vomiting, imbalance and increased
      risk of fall . Among all vestibular disorders, BPPV accounts for almost 20% and mostly
      affects the female gender as compared to the male gender. This type of disorder mainly
      involves the remoteness of otoliths in the semi-circular canal; most commonly the posterior
      canal is involved.

      A comparative study on posterior canal BPPV including modified Epley procedure alone and
      Epley procedure combined with vestibular rehabilitation. This cross sectional study
      illustrated that the results of Epley maneuver only were as same as effectual as with
      VRT(vestibular Rehabilitation therapy) by reducing the symptoms of residual unsteadiness in
      that particular population. Among all vertiginous disorders BPPV is most common. Vestibular
      rehabilitation was conducted as therapeutic option and its effects on balance and quality of
      life were being assessed. Dizziness Handicap Inventory was being used as outcome measure
      scale.

      The difference in signs of dizziness and quality of life in benign paroxysmal positional
      vertigo were investigated. Three groups were taken including one with BPPV, the second one
      with balance deficits (non-BPPV) and the last group involved healthy participants. The study
      concluded that the patients with BPPV had reduced HRQOL (health related Quality of life),
      tiredness and increased risk of fall. Dizziness associated with bed mobility is an indicator
      for the need of diagnoses and treatment thus, repositioning maneuvers had good impact on
      reducing the severity.

      The effects of conventional vestibular rehabilitation recurrence rates on benign paroxysmal
      positional vertigo aimed to find the impacts on otolith dysfunction. Although repositioning
      movements were proved fruitful yet the recurrence rates were high in older population as
      compared to young. Vestibular therapy including habituation exercises decreases the risks of
      recurrence in benign paroxysmal positional vertigo.

      As balance impairments are common in individuals with vertigo and dizziness. Proprioceptive
      training was proved more efficient than vestibular therapy in reducing the chances of fall in
      elder population. BBS (berg balance scale) and TUG (Time up and Go test) were conducted to
      assess balance and risk of fall in older people.

      Systematic review of the previous literature on the efficacy of vestibular rehabilitation
      therapy in benign paroxysmal positional vertigo.12 studies were based on inclusion criteria
      and the effectiveness of vestibular rehabilitation only and in combination with repositioning
      maneuver and also in comparison with it. Habituation exercises were included in VR
      therapeutic intervention, Conclusion were in favor of vestibular therapy as it showed
      reduction in discomfort caused by the condition.

      Efficacy of vestibular therapy protocol to determine its effects on quality of life and
      postural balance. Randomized controlled trial was performed on 20 individuals. Outcome
      measure scales like DHI (dizziness handicap inventory), VAS (vertigo visual analogue scale)
      were used and it was observed that with vestibular rehabilitation there were consequences
      like better quality of life and reduced signs of vertigo and dizziness were achieved.

      According to previous study there was a lack of control group in previous evidence whereas
      this study will focus on control as well as interventional groups. In previous literature,
      both of these therapeutic options i.e., habituation exercises and proprioceptive training
      were used in combination but in this study the comparison will be done between two exercise
      protocols.

      Consequences will be manipulated for balance, vertigo, dizziness and quality of life.
    

Intervention name(s): Habituation exercises + vestibular treatment; proprioceptive training + vestibular therapy; conventional vestibular treatment
Intervention type(s): Other; Other; Other
Intervention description(s): Exercises will include Intensity: 10 repetitions of each set Frequency= 3 sessions per week for 6 weeks.
Time= 30 minutes; Exercise protocol will include Time= total session of 30 minutes . Each exercise will be hold for 30 seconds . Frequency= 3 session per week for 6 weeks Intensity= 10 repetitions and 3 sets; Epley's Manuever. Frequency= It will be performed once in a week . Time= 10-15 minutes per session
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Habituation exercises; Proprioceptive training; Vertigo; Dizziness; Balance; benign paroxysmal positional vertigo