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Comparison of the Efficacy of Vestibular Rehabilitation and Pharmacological Treatment in Benign Paroxysmal Positional Vertigo

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Abstract

Aim: The aim of the study is to compare the effects of vestibular rehabilitation and pharmacological treatment in benign paroxysmal positional vertigo (BPPV). Materials and methods: Thirty patients (40.93 ± 8.66 years old) diagnosed with BPPV were recruited. Patients were equally divided into pharmacological control group and vestibular rehabilitation group. The pharmacological control group was further divided into Group A (n = 8, 2 doses/day, 24 mg betahistine) and Group B (n = 7, 1 dose/day, 50 mg dimenhydrinate in addition to betahistine). Patients in the rehabilitation group underwent repeated head and eye movements, and Epley or Barbecue Roll Maneuvers were applied for 4 weeks. Subjective assessment of vertigo was measured with the visual analog scale. Static balance parameters were measured with the tandem, one-legged stance, and Romberg tests. Dynamic visual acuity was measured with a Snellen chart, and vestibular dysfunction was measured with the Unterberger (Fukuda stepping) test. All parameters were evaluated before and after treatment. Results: Vestibular rehabilitation resulted in greater improvement in severity of vertigo, balance parameters except Romberg test, and vestibular dysfunction than pharmacological therapy (p < 0,001). There was no significant difference in dynamic visual acuity between groups (p = 0,24). The effects of medication with the active ingredients betahistine and dimenhydrinate were similar (p > 0,05). Conclusion: The vestibular rehabilitation method can positively change the severity of vertigo, balance ability, and vestibular dysfunction compared to pharmacological therapy. Dimenhydrinate administered in combination with betahistine was not superior to betahistine alone but can be recommended for its antiemetic effect.

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Acknowledgment

We would like to thank Prof. Dr. Z. Candan ALGUN for her guidance on the study design.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey

    Görkem ATA & Gamze Kılıç

  2. School of Medicine, Department of Medical Pharmacology, Istanbul Medipol University, Istanbul, Turkey

    Ayşe Arzu ŞAKUL

  3. Istanbul Gunesli Erdem Hospital, Otorhinolaryngology Clinic, Istanbul, Turkey

    Cengiz ÇELİKYURT

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  1. Görkem ATA
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Correspondence to Görkem ATA.

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Patients signed informed consent regarding publishing their data.

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This study was performed in line with the princi-ples of the Declaration of Helsinki. Ethics approval was obtained from the Istanbul Medipol University Non-Interventional Clinical Research Ethics Committee. (E-19383).

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NCT05127694.

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ATA, G., ŞAKUL, A.A., Kılıç, G. et al. Comparison of the Efficacy of Vestibular Rehabilitation and Pharmacological Treatment in Benign Paroxysmal Positional Vertigo. Indian J Otolaryngol Head Neck Surg 75 (Suppl 1), 483–490 (2023). https://doi.org/10.1007/s12070-023-03598-4

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