Evaluating the effectiveness of brandt daroff exercises compared to epley maneuver and the effect of postural restriction after performing epley maneuver on the quality of life in benign paroksismal positional vertigo (BPPV)

The purpose of this study is to evaluate the effectiveness of Brandt Daroff exercises compared to Epley maneuver, the effect of postural restriction after performing Epley maneuver on the quality of life indices of patients who were admitted with the complaints of positional vertigo and were diagnosed as benign paroxysmal positional vertigo (BPPV). A total of 96 patients between 18 and 80 years old who were referred to the Department of Otorhinolaryngology of Inonu University Faculty of Medicine Hospital between January 2010 and September 2015 complaining of positional vertigo who were diagnosed as BPPV with the Dix Hallpike (DH) test were enrolled in a prospective, controlled study. Thirty six (%37.5) of the patients were male and 60 (%62.5) were female. The patients were randomly divided into 3 groups , each consisting of 32 patient. Epley maneuver was performed to the first group ( Epley +Postural restriction group) , postural restrictions were proposed after the maneuver. Epley maneuver was performed to the second group ( Epley + free movement group) and free movement was suggested to all the patients.The third group (Brandt Daroff group) did not get Epley maneuver. Brandt Daroff exercises were taught to third group and they were asked to practice at home. At the initial visit , in groups which Epley maneuver practiced, 28 patients (%88,23) from free movement group and 27 patients from postural restriction group (%85,29) were totally recovered. Nine patients from both groups having nystagmus and vertigo during the Dix-Hallpike Test (DHT) were underwent Epley maeuver again. At the first month visit 2 patients from both group were underwent Epley Maneuver for the third time.Recovery rates at both groups were %97,05 at first month. Twelve (%35,2) patients from the group Brandt Daroff exercises suggested were fully recovered at the initial visit at the first week. In this group 13 patients (%38,23) had still nystagmus and vertigo during the DHT. At the end of the first mounth recovery rates were significantly higher in the first two groups which Epley maneuver performed compared to the Brandt Daroff group (p< 0,005). Dizziness Handicap Inventory (DHI) was used to evaluate the effect of BPPV on daily life of the patients. The patients were asked DHI at the first visit when they accepted fully recovered. The scores of answers collected and in the range of 0-100 scores were obtained. Higher scores were indicating more severe disability. The scores obtained from questions related to physically , emotional and functional areas of the life were significantly lower than Brandt Daroff group in the first two groups (p<0,005). As a result, In our study we found that there was no effect of postural restriction at first week and first month after performing Epley maneuver.Brandt Daroff exercises were not sufficient alone for total recovery compared to Epley manuver.Epley maneuver was more effective on the quality of life of the patients compared to Brandt Daroff exercises. Key words: BPPV, Dix Hallpike Test , Epley Maneuver, Brandt Daroff exercises