ABSTRACT
Abstract Introduction: The Epley maneuver is applied in the treatment of benign paroxysmal positional vertigo, the BPPV. However, dizziness and balance problems do not improve immediately after the treatment. Objective: In this study, the effectiveness of the head-shaking maneuver before the Epley maneuver was investigated in the treatment of BPPV. Methods: Between March 2020 and August 2020, ninety-six patients with posterior semicircular canal BPPV were analyzed prospectively. The patients were divided into two groups: patients who underwent the Epley maneuver only in the treatment (Group 1) and patients who underwent the Epley maneuver after the head-shaking maneuver (Group 2). The results of the Berg balance scale and dizziness handicap index were evaluated before the treatment and at the first week after the treatment. Results: The improvement in functional, emotional, and physical dizziness handicap index and Berg balance scale values after the treatment was found to be statistically significant in both groups. It was determined that the change in functional and physical dizziness handicap index and Berg balance scale values of the patients in Group 2 was statistically higher than those in Group 1. Although, the change in emotional dizziness handicap index values in Group 2 was higher than those in Group 1, no statistical significance was found between the groups. Conclusion: As a result of our hypothesis, we think that in the treatment of posterior semicircular canal BPPV, the otoliths adhered to the canal can be mobilized by the head-shaking maneuver, and this will contribute to the increase of the effectiveness of the Epley maneuver.
Resumo Introdução: A manobra de Epley é aplicada no tratamento da vertigem posicional paroxística benigna (VPPB). Entretanto, a tontura e os problemas de equilíbrio não melhoram imediatamente após o tratamento. Objetivo: Investigar a eficácia da manobra de balançar a cabeça antes da manobra de Epley no tratamento da VPPB. Método: De março de 2020 a agosto de 2020, 96 pacientes com VPPB de canal semicircular posterior foram analisados prospectivamente. Os pacientes foram divididos em dois grupos: pacientes que foram submetidos apenas à manobra de Epley no tratamento (Grupo 1) e pacientes que foram submetidos à manobra de Epley após a manobra de balanço da cabeça (Grupo 2). Os resultados da escala de equilíbrio de Berg e do dizziness handicap index foram avaliados antes do tratamento e na primeira semana após o tratamento. Resultados: A melhoria nos valores funcionais, emocionais e físicos do dizziness handicap index e da escala de equilíbrio de Berg após o tratamento foi estatisticamente significante em ambos os grupos. Foi determinado que a alteração nos valores funcionais e físicos do dizziness handicap indexe da escala de equilíbrio de Berg dos pacientes do Grupo 2 foi significantemente maior do que aqueles do Grupo 1. Embora a alteração nos valores do dizziness handicap index emocional no Grupo 2 tenha sido maior do que no Grupo 1, não houve significância estatística entre os grupos. Conclusão: Como resultado de nossa hipótese, acreditamos que no tratamento da VPPB do canal semicircular posterior os otólitos aderidos ao canal podem ser mobilizados através da manobra de balanço da cabeça, o que contribuirá para o aumento da eficácia da manobra de Epley.
ABSTRACT
INTRODUCTION: The Epley maneuver is applied in the treatment of benign paroxysmal positional vertigo, the BPPV. However, dizziness and balance problems do not improve immediately after the treatment. OBJECTIVE: In this study, the effectiveness of the head-shaking maneuver before the Epley maneuver was investigated in the treatment of BPPV. METHODS: Between March 2020 and August 2020, ninety-six patients with posterior semicircular canal BPPV were analyzed prospectively. The patients were divided into two groups: patients who underwent the Epley maneuver only in the treatment (Group 1) and patients who underwent the Epley maneuver after the head-shaking maneuver (Group 2). The results of the Berg balance scale and dizziness handicap index were evaluated before the treatment and at the first week after the treatment. RESULTS: The improvement in functional, emotional, and physical dizziness handicap index and Berg balance scale values after the treatment was found to be statistically significant in both groups. It was determined that the change in functional and physical dizziness handicap index and Berg balance scale values of the patients in Group 2 was statistically higher than those in Group 1. Although, the change in emotional dizziness handicap index values in Group 2 was higher than those in Group 1, no statistical significance was found between the groups. CONCLUSION: As a result of our hypothesis, we think that in the treatment of posterior semicircular canal BPPV, the otoliths adhered to the canal can be mobilized by the head-shaking maneuver, and this will contribute to the increase of the effectiveness of the Epley maneuver.