The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

Introduction & Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR) therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV). In a clinical trial design, 46 patients older than 60 years (aged 61 to 72 years) with BPPV who referred to the ENT center of Imam Khomeini Hospital, Ahwaz, were studied. After an otologic evaluation, videonystagmography and dizziness handicap inventory (DHI) evaluations were performed for each case. Then, vestibular rehabilitation (VR) therapy was carried out by means of Epley maneuver. Efficacy of a VRT was tested by comparing pre-treatment with post-treatment VNG and DHI assessments. The data were analyzed by SPSS 16 software. The average age of the patients was 67.28 ± 4.5 years. VR caused normal Hallpike findings in 31 (67.4 %) and noticeable reduction in nystagmus amplitudes in 9 patients. We found a significant correlation between nystagmus amplitudes and DHI scores (r=0.77). The mean DHI scores decreased from 53.26±16.12 points to 15.36±9.23 points (p<0.001) at the end of the treatment course. Our investigation revealed that VR plays an important role in reducing vertigo in at-risk elderly patients. Lack of appropriate treatment in this population may cause a serious balance problem (such as bone fracture and long-term handicap) that may interfere with their daily activities.