Research Article

Modified clinical test of sensory interaction on balance test use for assessing effectiveness of Epley maneuver in benign paroxysmal positional vertigo patients rehabilitation

Abstract

Background and Aim: Benign paroxysmal positional vertigo (BPPV) is most common type of vertigo in general population. Epley maneuver is the most effective treatment technique. However, there is no clinically valid test to verify effectiveness of maneuver quickly after treatment in the same session. Modified clinical test of sensory interaction on balance (mCTSIB) is considered as a quick and simple test. This study aimed to use mCTSIB for assessing effectiveness of Epley maneuver in BPPV patients.
Methods: The study was carried out on 44 patients (36 female and 8 male, mean age of 53.11 (SD=7.09) diagnosed with posterior semicircular canals BPPV in Dix-Hallpike test and no other vestibular disorders. mCTSIB in four conditions was assessed, before and after Epley maneuver. Balance time, lateral and anterior-posterior sway were recorded. mCTSIB repeated after three weeks to assess reliability.
Results: The time for balance control in mCTSIB after maneuver did not change significantly relative to before maneuver (p>0.05). Lateral sway changes in conditions 2, 3 and 4 in mCTSIB significantly reduced after maneuver (p=0.04). Anterior-posterior sway changes in conditions 1 and 2 showed no significant difference after maneuver, however, differences in conditions 3 and 4 were statistically significant (p<0.05). Test-retest showed reliable results.
Conclusion: mCTSIB is seems be a valid test with simple and quick apply for verifying the effectiveness of Epley maneuver in BPPV patients.

1. Gazzola JM, Ganança FF, Aratani MC, Perracini MR, Ganança MM. Circumstances and consequences of falls in elderly people with vestibular disorder. Braz J Otorhinolaryngol. 2006;72(3):388-92.
2. Norré ME. Sensory interaction posturography in patients with benign paroxysmal positional vertigo. Clin Otolaryngol Allied Sci. 1993;18(3):226-30.
3. Chang TP, Lin YW, Sung PY, Chuang HY, Chung HY, Liao WL. Benign paroxysmal positional vertigo after dental procedures: a population-based case control study. PLoS One. 2016;11(4):e0153092. doi: 10.1371/journal.pone.0153092
4. von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710-5. doi: 10.1136/jnnp.2006.100420
5. Vaz DP, Gazzola JM, Lança SM, Dorigueto RS, Kasse CA. Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo. Braz J Otorhinolaryngol. 2013;79(2):150-7.
6. Richard W, Bruintjes TD, Oostenbrink P, van Leeuwen RB. Efficacy of the epley maneuver for posterior canal BPPV: a long-term, controlled study of 81 patients. Ear Nose Throat J. 2005;84(1):22-5.
7. Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003;169(7):681-93.
8. Atlas JT, Parnes LS. Benign paroxysmal positional vertigo: mechanism and management. Curr Opin Oto¬laryngol Head Neck Surg. 2001;9(5):284-9.
9. Wolf JS, Boyev KP, Manokey BJ, Mattox DE. Success of the modified Epley maneuver in treating benign paroxysmal positional vertigo. Laryngoscope. 1999;109(6):900-3.
10. Steenerson RL, Cronin GW, Marbach PM.. Effectiveness of treatment techniques in 923 cases of benign paroxysmal positional vertigo. Laryngoscope. 2005;115(2):226-31. doi: 10.1097/01.mlg.0000154723.55044.b5
11. Yimtae K, Srirompotong S, Srirompotong S, Sae-Seaw P. A randomized trial of the canalith repositioning procedure. Laryngoscope. 2003;113(5):828-32. doi: 10.1097/00005537-200305000-00011
12. Cohen H, Blatchly CA, Gombash LL. A study of the clinical test of sensory interaction and balance. Phys Ther. 1993;73(6):346-51; discussion 351-4.
13. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction of balance. Suggestion from the field. Phys Ther. 1986;66(10):1548-50.
14. Park MK, Kim KM, Jung J, Lee N, Hwang SJ, Chae SW. Evaluation of uncompensated unilateral vestibulopathy using the modified clinical test for sensory interaction and balance. Otol Neurotol. 2013;34(2):292-6. doi: 10.1097/MAO.0b013e31827c9dae
15. Wrisley DM, Whitney SL. The effect of foot position on the modified clinical test of sensory interaction and balance. Arch Phys Med Rehabil. 2004;85(2):335-8.
16. Mulavara AP, Cohen HS, Peters BT, Sangi-Haghpeykar H, Bloomberg JJ. New analyses of the sensory organization test compared to the clinical test of sensory integration and balance in patients with benign paroxysmal positional vertigo. Laryngoscope. 2013;123(9):2276-80. doi: 10.1002/lary.24075
17. Zhou R, Liu B, Zhang S, Liu D, Liu J, Leng Y, et al. [The balance function of the patients with benign paroxysmal positional vertigo during standing]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015;29(22):1966-9. Chinese.
18. Herdman SJ, Hoder JM. Physical therapy management of benign paroxysmal positional vertigo. In: Herdman SJ, Clendaniel RA. Vestibular rehabilitation. 4th ed. Philadelphia: F. A. Davis Company; 2014. p. 324-58.
19. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156(3_suppl):S1-S47. doi: 10.1177/0194599816689667
20. Casqueiro JC, Ayala A, Monedero G. No more postural restrictions in posterior canal benign paroxysmal positional vertigo. Otol Neurotol. 2008;29(5):706-9. doi: 10.1097/MAO.0b013e31817d01e8
21. Cohen HS, Jerabek J. Efficacy of treatments for posterior canal benign paroxysmal positional vertigo. Laryngoscope. 1999;109(4):584-90. doi: 10.1097/00005537-199904000-00012
22. von Brevern M, Seelig T, Radtke A, Tiel-Wilck K, Neuhauser H, Lempert T. Short-term efficacy of Epley's maneuver: a double-blind randomized trial. J Neurol Neurosurg Psychiatry. 2006;77(8):980-2. doi: 10.1136/jnnp.2005.085894
23. Chang WC, Hsu LC, Yang YR, Wang RY. Balance ability in patients with benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2006;135(4):534-40. doi: 10.1016/j.otohns.2005.10.001
24. Macedo C, Gazzola JM, Ricci NA, Doná F, Ganança FF. Influence of sensory information on static balance in older patients with vestibular disorder. Braz J Otorhinolaryngol. 2015;81(1):50-7. doi: 10.1016/j.bjorl.2014.11.004
25. Amor-Dorado JC, Barreira-Fernandez MP, Arias-Nuñez MC, Gomez-Acebo I, Llorca J, Gonzalez-Gay MA. Benign paroxysmal positional vertigo and clinical test of sensory interaction and balance in systemic sclerosis. Otol Neurotol. 2008;29(8):1155-61. doi: 10.1097/MAO.0b013e31818a086e
26. El-Kashlan HK, Shepard NT, Asher AM, Smith-Wheelock M, Telian SA. Evaluation of clinical measures of equilibrium. Laryngoscope. 1998;108(3):311-9.
27. Lotfi Y, Kahlaee AH, Sayadi N, Jalilzadeh Afshari P, Bakhshi E. Test-retest reliability of the pediatric clinical test of sensory interaction for balance in 4-6 years old children. Aud Vest Res. 2017;26(4):202-8.
28. Zhang DG, Fan ZM, Han YC, Yu G, Wang HB. [Clinical value of dynamic posturography in the evaluation and rehabilitation of vestibular function of patients with benign paroxysmal positional vertigo]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010;45(9):732-6. Chinese.
29. Okhovat AR, Berjis NAD, Naghdi S. [Assessment and comparison of the effectiveness of epley and semont maneuvers in treatment of benign paroxysmal positional vertigo (BPPV)]. J Isfahan Med Sch. 2003;20:36-8. Persian.
30. Rabiei S. [Comparison of effectiveness of epley"s- and semont"s maneuver in the treatment of BPPV]. Iran J Otorhinolaryngol. 2005;17(1):40-5. Persian.
Files
IssueVol 27 No 1 (2018) QRcode
SectionResearch Article(s)
Keywords
Benign paroxysmal positional vertigo Epley postural control

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Lotfi Y, Javanbakht M, Sayaf M, Bakhshi E. Modified clinical test of sensory interaction on balance test use for assessing effectiveness of Epley maneuver in benign paroxysmal positional vertigo patients rehabilitation. Aud Vestib Res. 2017;27(1):12-18.