Evaluation of recurrent therapy maneuvers in individuals with benign paroxysmal positional vertigo

Vertigo, an illusion of movement, is the main symptom of vestibular dysfunction. The most common cause of vertigo is Benign Paroxysmal Positional Vertigo. BPPV is a peripheral vestibular disease characterized by brief, episodic, transient episodes of vertigo, which is the perception that the environment or the person is spinning with head movement. This study has been conducted to analyze the effect of the number of Epley maneuvers used in the treatment of posterior semicircular canal BPPV on the recovery rates of patients. The effect of the change in the recovery results of the patients on the Vertigo Symptom Scale-Short Form (VSS-SF) and Dizziness Handicap Inventory (DHI) results have been investigated. In this study, A total of 124 patients, aged 19-86 years, diagnosed with posterior canal BPPV by the Dix-Hallpike (DH) test have been included. The patients have been evaluated in two groups. The Epley maneuver has been performed only once in the first group. Epley maneuver has applied to the other group twice on the same day. Both groups have been called for control after 1 week. Vertigo Symptom Scale responses and Dizziness Disability Inventory responses of the patients in both groups have been recorded and evaluated before and after the Epley maneuver. According to the DH test results, a significant difference has been found between the groups in the decrease in nystagmus degrees according to the type of application (p<0.05). A significant difference has been found between positivity and negativity rates according to the number of applications of DH (p<0.05). There have not a statistically significant difference in the change in the number of Epley applications between the groups in the DHI results (p>0.05). The variation of VSS-Vertigo scores between groups according to time has statistically significant (p<0.05). The variation of VSS-Anxiety scores according to time within the group has statistically significant (p<0.05). Conclusion: It has been determined that the application of more than one sequential Epley to patients with BPPV has reduced the degree of nystagmus in the patients and increased the rate of negative results in DH compared to the application only once. According to the DHI results, it has been observed that it contributed positively to the physical, functional, and emotional states of the patients, regardless of the number of Epley maneuver applications. In VS-Vertigo, the variation of scores between groups according to time has found to be statistically significant. According to these results it has been determined that the variation of VSS-Anxiety scores according to time within the group has statistically significantly, and applying more than one maneuver in the same session provided a significant decrease in the severity of vertigo and anxiety rates. Keywords: BPPV, Epley Maneuver, DHI, VSS-SF