Evaluation of the effectiveness of cawthorne-cooksey exercises applied with epley maneuver in patients with benign paroxysmal positional vertigo (BPPV)

BPPV is a treatable peripheral vestibular system disease that affects the quality of life and balance of patients. The aim of this study is to evaluate the effectivity of additional Cawthorne Cooksey exercises to Epley maneuver on these parameters in BPPV. 32 patients with posterior canal BPPV were included in the study and the patients were divided into two groups, which is maneuver group (n = 18) and maneuver and exercise group (n = 14). All patients were treated with maneuver, maneuver and exercise group patients were also asked to do the vestibular exercises in addition to the maneuver as a home programme twice a day and repeated 10 times for 6 weeks. Postural restriction was recommended for all patients. Pre-treatment quality of life was assessed by Dizziness Handicap Inventory (DHI) and Nottingham Health Profile (NHP); symptoms associated with dizziness were assessed by Vertigo Symptom Scale (VSS); dynamic balance was examined by Berg Balance Test (BBT) and static balance was examined via Nintendo Wii device and patients' vertigo and nystagmus were assessed by Dix-Hallpike (D-H) test. These measurements were repeated at 1.,3. and 6 weeks after treatment. The mean age of the patients were 46,91± 9,78 years and 24 (75%) were female and 8 (25%) were male. Right BPPV was detected in 21 patients (65.6%) and left BPPV in 11 patients (34.4%). Success was achieved in 25 (78.1%) patients in the first week, 6 (18.8%) patients in the third week and 1 (3,1%) patient in the sixth week D-H test controls. Except first week NHP-Energy parameter, repeated NHP and DHI results before and after treatment showed a statistically insignificant increase in patients' quality of life levels and no significant decrease was found in our VSS results (p> 0,05). There was improvement in the static and dynamic balance scores of the patients after treatment compared to pre-treatment, but statistically significant difference was not found between the groups except for pre-treatrment single leg stance with eyes closed (seconds) and 6th week single leg stance with eyes open (%) (p>0,05). According to the results of our study, it seems sufficient to apply Epley maneuver as the first option in patients with BPPV. Key Words: BPPV, maneuver, Cawthorne-Cooksey, quality of life, balance