Balance improvement in patients with benign paroxysmal positional vertigo Balance disorders in the elderly and the benefit of balance exercise. Effects of balance Vestibular Rehabilitation Therapy in elderly with Benign Paroxysmal Positional Vertigo: a randomized controlled trial Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo. Systematic approach to benign paroxysmal positional vertigo in the elderly. “Positive to Negative” Dix-Hallpike test and Benign Paroxysmal Positional Vertigo recurrence in elderly undergoing Canalith Repositioning Maneuver and Vestibular Rehabilitation The number of procedures required to eliminate positioning nystagmus in benign paroxysmal positional vertigo. Dizziness in an older community dwelling population: A multifactorial syndrome The effect of the canalith repositioning maneuver on resolving postural instability in patients with benign paroxysmal positional vertigo. Treatment of benign positional vertigo in the elderly: a randomized trial. Effectiveness of Treatments for Benign Paroxysmal Positional Vertigo of the Posterior Canal The canalith repositioning procedure for the treatment of benign paroxysmal positional vertigo: a randomized controlled trial. Postural Control in Older Patients with Benign Paroxysmal Positional Vertigo Efficacy of particle repositioning maneuver in BPPV: a prospective study. Is it important to restrict head movement after Epley maneuver? Falls in patients with vestibular deficits. Dizziness in community-dwelling older adults: a population-based study.
Objective : To investigate the effect of an additional vestibular stimulated exercise programme on balance for patients with benign paroxysmal positional vertigo . Design : R and omized controlled trial . Setting : Medical centre . Subjects : Twenty-six subjects with benign paroxysmal positional vertigo involving the unilateral posterior semicircular canal . Interventions : Subjects were r and omized into experimental or control groups . Thirteen subjects in the experimental group received the canalith repositioning manoeuvre and vestibular stimulated exercise training three times a week for four weeks . Thirteen subjects in the control group received only the canalith repositioning manoeuvre . Main measures : Static balance tests , t and em walk test , Dynamic Gait Index and subjective rating of the intensity of vertigo were measured at baseline , two-week and four-week assessment s. Results : Compared with the control group , subjects in the experimental group demonstrated a statistically significant improvement in single leg stance with eyes closed at the two-week assessment ( P<0.05 ) . Furthermore , stance on foam surface with eyes closed , single-leg stance with eyes closed , and Dynamic Gait Index at the four-week assessment were also significantly improved ( P<0.05 ) . Conclusion : The present study demonstrated that additional exercise training , which emphasizes vestibular stimulation , can improve balance ability and functional gait performance among patients with benign paroxysmal positional vertigo who had already undergone the canalith repositioning manoeuvre Symptoms of balance disorders including ' unsteadiness ' , ' dizziness and vertigo ' are common in the elderly and commonly found in general practice in medicine . There are many causes of balance disorders and vary from one person to another . Disorder of the internal ear or vestibular end-organ type is one cause . Unsteadiness of somato-sensory or proprioception is common in the elderly so is degenerative disorder of central control in brain . The elderly are prone to many chronic illnesses or disorders which are causes of balance disorder or give rise to more rapid degeneration of the central nervous system i.e. high blood pressure , diabetes mellitus , heart disease , proprioception and joint problems , arthritis and muscular weakness due to lack of good health and exercise . The objectives of this research study were to find the etiologies of balance disorders and how Balance Exercises and the ' National Health Service ' can be of benefit in helping to prevent them . 1565 elderly inhabitants ( age > or = 60 years ) of 20 communities adjacent to Siriraj Hospital were selected for study . Among these , 625 persons had a history of balance disorders . Among those , 256 had symptoms during the week selected for examination . The average age was 66 years old , women outnumbered men with a ratio of 2.4:1 . The common underlying causes were hypertension in 32.4 % , diabetes mellitus 13.8 % , arthritis 8.1 % , and heart disease 4.4 % respectively . All are still taking one or more types of drug . The subjects were r and omly divided into two groups for the study purpose of effectiveness of balance exercise . Group 1 did not perform the head balance exercise and Group 2 performed the head balance exercise . Audiometric testing showed impaired hearing in 90 % of the subjects . The majority slowed hearing loss in high frequencies . Testing of middle ear function found 75 % of Group 1 to have normal middle ear function 77 % of Group 2 . Brainstem Electrical Response Audiometry ( BERA ) showed normal response latencies of in 96 % of group 1 and 94 % of Group 2 . Poor morphology of waveform was found in 12 % of Group 1 and 16 % of Group 2 . Doppler sonography for intra-cranial blood flow measurement showed abnormal flow of the ICA in 17.6 % of group 1 and 20.16 % of group 2 . Basilar arterial abnormal flow was found in 77.6 % of Group 1 and 80.6 % of Group 2 respectively . The flow of ICA was improved after 8 weeks in both groups . The measurement of balance by Posturography showed 86.7 % abnormality in Group 1 and 83.5 % abnormality in Group 2 ( and the majority due to inner ear problems but many cases had a mixture of joints and CNS problems too ) . Results of the self-evaluation ( by question aires ) showed the elderly to have symptoms of light headedness in 51 % and loss of balance in 29 % , Vertigo with rotation occurred in 23.6 % . 49 % of the symptoms were intermittent , 56.4 % experienced a ' fall " . On question ing about the benefit and performance of Head and Neck Exercises , 82.8 % found the exercises were easy to perform , 56.4 % said the results were very beneficial Abstract Purpose : To evaluate short-term effects of balance Vestibular Rehabilitation Therapy ( VRT ) on balance , dizziness symptoms and quality of life of the elderly with chronic Benign Paroxysmal Positional Vertigo ( BPPV ) . Method : In this r and omized , single-blind and controlled trial , older adults with chronic BPPV were r and omized into two groups , the experimental group ( n = 7 , age : 69 ( 65–78 ) years ) and the control group ( n = 7 , age : 73 ( 65–76 ) years ) . Patients in the experimental group underwent balance VRT ( 50 min per session , two times a week ) and Canalith Repositioning Maneuver ( CRM ) as required , for 13 weeks . The control group was treated using only CRM as required . St and ing and dynamic balance , dizziness symptoms and quality of life were measured at the baseline , and at one , five , nine and thirteen weeks . Results : There were no between-group differences in dizziness , quality of life and st and ing balance over the 13 weeks . Significant differences were observed in dynamic balance measures between groups ( p < 0.05 for most tests ) through assessment s. In intragroup analysis , both groups showed improvements in all measurements except no improvement was found in majority of the dynamic balance tests in the control group . Conclusions : The patients who received additional balance VRT demonstrated better results in dynamic balance than those who received only CRM . Implication s for Rehabilitation The findings that balance VRT in addition to CRM improves dynamic balance in elderly people with BPPV should be useful in guiding rehabilitation professionals ’ clinical decision making to design interventions for seniors suffering from BPPV ; Improvements in tests of dynamic balance suggest that the risk of adverse consequences of BPPV in the elderly such as falls and fractures can be potentially reduced through implementation of CRM in conjunction with balance VRT ; Lack of additional improvement in Visual Analogue Scale of dizziness and Dizziness H and icap Index suggests that addition of balance VRT does not influence dizziness symptomatology , per se , and CRM alone is effective to ameliorate vertiginous symptoms and potentially improve quality of life UNLABELLED Benign paroxysmal positional vertigo ( BPPV ) may compromise the balance of elderly subjects . OBJECTIVE To observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance . METHOD This is a prospect i ve clinical study . Patients diagnosed with BPPV ( Dix-Hallpike test ) were su bmi tted to the Timed Up & Go ( TUG ) test , the Clinical Test of Sensory Interaction and Balance ( CTSIB ) , and lower limb testing before and after they were repositioned using the modified Epley maneuver . RESULTS Most subjects were females , and the group 's mean age was 70.10 years ( SD = 7.00 ) . All patients had canalithiasis of the posterior canal . The following symptoms improved after the maneuver : postural instability ( p = 0.006 ) , nausea and vomiting ( p = 0.021 ) , and tinnitus ( p = 0.003 ) . Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver ( p < 0.001 ) . Patients performed better on the CTSIB after the Epley maneuver  on condition 2 ( p < 0.003 ) , condition 3 ( p < 0.001 ) , condition 4 ( p < 0.001 ) , condition 5 ( p < 0.001 ) , and condition 6 ( p < 0.001 ) . CONCLUSION Clinical and functional aspects of body balance in elderly with BPPV improved after treatment with the modified Epley maneuver OBJECTIVE We evaluated the effectiveness of a management approach that combines the canalith repositioning maneuver ( CRM ) and vestibular rehabilitation ( VR ) in the treatment of benign positional paroxysmal vertigo ( BPPV ) in elderly persons . STUDY DESIGN AND SETTING Forty-seven patients ( > /=70 years old ) with the diagnosis of unilateral posterior semicircular canal BPPV formed the study population . This study has 2 parts . In the first part , patients were r and omly assigned to 1 of 2 groups : the CRM and avoidance ( no treatment ) . Patients were evaluated 1 month after the first visit . Those patients not responding to treatment were enrolled in the second part of the study , treated with an individualized combination of CRM and VR , and then reevaluated 3 months later . RESULTS Statistically significant improvement of vertigo and provoked nystagmus in 64 % of patients in the CRM group compared with the no-treatment group . After the addition of VR , 77 % of all patients improved . CONCLUSION A combination of CRM and VR improves  BPPV in the elderly . SIGNIFICANCE These findings suggest that although CRM is more effective than no treatment , VR can be added to improve the results in the treatment of BPPV Introduction Benign Paroxysmal Positional Vertigo is the most common cause of dizziness in elderly people . Recent studies have shown that the elderly present higher Benign Paroxysmal Positional Vertigo recurrence and that vertiginous symptomatology remission varies according to comorbidities and the therapeutic techniques applied . Objective To assess the short-term effectiveness of Vestibular Rehabilitation in addition to Canalith Repositioning Maneuver on positive to negative Dix-Hallpike test , on recurrence and number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo . Methods In this r and omized controlled trial , 7 older adults ( median age : 69 years , range 65–78 ) underwent Canalith Repositioning Maneuver and Vestibular Rehabilitation for thirteen weeks . Seven older adults ( median age : 73 years , range 65–76 ) in the control group received only Canalith Repositioning Maneuver . The participants were assessed at baseline ( T0 ) , one ( T1 ) , five ( T5 ) , nine ( T9 ) , and thirteen weeks ( T13 ) . We assessed the differences between the groups by Mann-Whitney and Fisher exact tests , and used the Friedman and Wilcoxon tests to determine the intragroup differences . Results No significant differences were found between groups for the positive to negative Dix-Hallpike test , recurrence , and number of maneuvers to achieve a negative test . The number of maneuvers to achieve negative Dix-Hallpike test was lower in intragroup comparisons in the experimental group . Conclusion The findings suggest that additional Vestibular Rehabilitation did not influence the positive to negative Dix-Hallpike test , recurrence , or number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo AIM To evaluate the number of weekly canalith repositioning procedures needed to eliminate positioning nystagmus in patients with benign paroxysmal positional vertigo and to verify influences of canalithiasis or cupulolithiasis and /or semicircular canal involvement . STUDY DESIGN clinical prospect i ve with transversal cohort . MATERIAL AND METHOD Sixty patients with benign paroxysmal positional vertigo were consecutively selected according to each combination of canalithiasis or cupulolithiasis with semicircular canal involvement . Patients were treated by means of canalith repositioning procedures repeated weekly until the elimination of the positioning nystagmus . Analysis of Variance was used to verify differences between the variables . RESULTS An average of 2.13 procedures ( from 1 to 8) was needed to eliminate the positioning nystagmus .  Canalithiasis required an average of 1.53 procedures , while cupulolithiasis needed 2.92 procedures ( p=0.0002 ) . An average of two procedures was needed to eliminate the positioning nystagmus in cases with posterior canal involvement , 2.39 procedures in cases with anterior canal involvement and 2.07 procedures in cases with lateral canal involvement ( p=0.5213 ) . CONCLUSIONS From one to eight weekly canalith repositioning procedures were needed , with an average of two , to eliminate positioning nystagmus in benign paroxysmal positional vertigo . Cupulolithiasis requires a greater number of procedures than canalithiasis to eliminate positioning nystagmus . Semicircular canal involvement did n't influence the number of therapeutic maneuvers Objectives The aim of this study was to determine the prevalence and related predictors of dizziness in a sample of community-dwelling people 65 years of age and older living in a metropolitan area in Germany . Design Prospect i ve cohort study . Setting Interdisciplinary Centre of Gerontology at the University of Erlangen-Nuremberg , Germany . Participants 6000 people aged 65 years and older recruited and r and omized from the registration office , 1801 were fully evaluated at baseline and were re-evaluated in a prospect i ve follow-up two years later . A full data set was obtained for 620 participants , of which 297 ( 47.9 % ) were females . Mean age was 73.45 ± 6.05 . 200 participants ( 32.4 % ) were 65–69 years , 315 ( 51 % ) were 70–79 years , 92 ( 14.9 % ) 80–89 years and 11 ( 1.8 % ) 90 years and older . Measurements Demographic , medical , functional and psychological factors were measured by a st and ardised question naire in 2004 . In a follow-up survey participants were reevaluated in a prospect i ve design two years later ( 2006 ) , including a dizziness question naire , containing frequency , duration , space of dizziness and releasing positions and activities . Results At the second measurement 181 persons ( 29.2 % ) reported dizziness in the last 6 months . Dizziness was age dependent , with a prevalence of 27 % in participants aged 70 years and younger , up to 54 % in the group of 90 years and older . 96 ( 68.2 % ) persons reported daily or weekly dizziness . 46 ( 27.9 % ) participants reported multiple sensations of dizziness . In 108 ( 59.7 ) persons dizziness was released by multiple positions or activities . The main predictors of dizziness were age , female gender , cardiovascular disease , osteoporosis , depression , sleep disorder , disturbance of memory , shortsightedness ( defined by glasses ) , incontinence , 3 and more medical conditions , 4 and more medications , poor health status , falls and mobility problems . We found similar risk factors for dizziness and falls . Conclusion Dizziness is a very common symptom in older community dwelling persons . Comorbidity , poor health status and mobility problems are strong medical predictors ; age and female gender and decline in mobility are important predictors as well . Our study suggests , that dizziness in older age is often caused by multifactorial medical and functional conditions . Gait disorders and mobility problems also seem to play an important role in dizziness among older people . Therefore , interventions in dizziness should be developed in a multifactorial way . We suggest , that the interventions to be tested first , should be those that have been previously successful in older persons with gait disorders and falls OBJECTIVE Patients with benign paroxysmal positional vertigo ( BPPV ) often experience postural instability as well as brief episodes of vertigo . The purpose of this study was to determine whether successful resolution of the episodic vertigo , through use of the canalith repositioning treatment , would be accompanied by improvement in postural stability . STUDY DESIGN Prospect i ve clinical study . SETTING Outpatient tertiary care facility in a university . PATIENTS Thirty-three patients with a diagnosis of the canalithiasis form of BPPV affecting the posterior canal unilaterally . All patients had complete remission of the positional vertigo after treatment . Patients with abnormal caloric or rotary chair test results were excluded from the study . INTERVENTION The posterior canal BPPV was treated by the canalith repositioning treatment . MAIN OUTCOME MEASURES Postural stability was assessed by  computerized dynamic posturography  before and 1 to 2 weeks after treatment . Six different subtests were used . RESULTS A significant number of patients had abnormal stability , as measured with computerized dynamic posturography , before treatment . After treatment there was a significant increase in the number of subjects with normal results on the different subtests ; however , not all patients had normal postural stability . Younger subjects were more likely to show improved stability . CONCLUSIONS Treatment of BPPV using the canalith repositioning treatment results in improved postural stability in patients with BPPV . Not all patients have normal stability after treatment , however , and assessment and treatment of the balance problems may be necessary OBJECTIVES /HYPOTHESIS The objective of the study was to evaluate the efficacy of three therapeutic strategies ( Semont maneuver , flunarizine , and no treatment ) in patients with benign paroxysmal positional vertigo . STUDY DESIGN R and omized prospect i ve trial . METHODS One hundred fifty-six consecutive patients older than 60 years of age who were affected by benign paroxysmal positional vertigo of the posterior semicircular canal were enrolled . The diagnosis was made on the basis of the history of recurrent sudden crisis of vertigo and positional-induced typical nystagmus after Dix-Hallpike positioning maneuver . Patients were r and omly allocated to receive Semont liberatory maneuver ( intended as a statoconia-detachment maneuver ) , flunarizine , or no treatment . A post-treatment negative Dix-Hallpike test result was considered as a proof of vertigo resolution . RESULTS Cure rates with Semont maneuver  were significantly higher ( 94.2 % ) than those obtained with flunarizine ( 57.7 % ) and no treatment ( 36.4 % ) ( P < .001 ) . Within a 6-month follow-up , relapse rates were lower among patients treated with Semont maneuver ( 3.8 % ) than those obtained with flunarizine ( 5.8 % ) and no treatment ( 21.1 % ) . All patients with resolution of symptoms and negative Dix-Hallpike test results showed a great improvement in daily activities and quality of life ( P < .001 ) . CONCLUSION Semont liberatory maneuver is the most successful therapy for benign paroxysmal positional vertigo and improves patients ' quality of life . Diagnostic and therapeutic maneuvers are easy to perform and should be part of the medical knowledge of every general practitioner and geriatrician Objective : To determine which common , nonpharmacological , nonsurgical treatments are most effective for treatment of benign paroxysmal positional vertigo ( BPPV ) . Study Design : Prospect i ve , r and omized , sham-controlled . Patients : Patients ( n = 124 ) with BPPV of the posterior semicircular canal . Setting : Tertiary care center . Interventions : R and om assignment to one of five groups : modified canalith repositioning maneuver ( CRP ) , modified liberatory maneuver ( LM ) , sham maneuver , Br and t and Daroff 's exercise , and vertigo habituation exercises . Subjects received a st and ard educational lecture about BPPV and the purpose of the intervention . No vestibular-suppressant medication or special instructions for head positioning were used . Post-tests were given at 1 week after treatment and at approximately 3 months and 6 months later . Main Outcome Measures : Vertigo intensity and frequency . Results : Multilevel analyses showed that vertigo decreased significantly after  LM , CRP  , and Br and  t-Daroff exercise ;  those three groups did not differ significantly . The habituation group did not differ from sham , Br and t-Daroff , LM , or CRP groups . Changes in scores were maintained throughout the 6-month follow-up period . Conclusion : LM , CRP , and exercises are all effective interventions ; patient education plus the sham maneuver , however , had some beneficial effect . These results support two possible mechanisms of BPPV : displaced otoconia and a neural mechanism affecting interpretation of semicircular canal signals OBJECTIVE To compare the canalith repositioning procedure ( CRP ) with a sham maneuver for the treatment of benign paroxysmal positional vertigo . PATIENTS AND METHODS We recruited 50 patients with a history of positional vertigo and unilateral positional nystagmus on physical examination ( Dix-Hallpike maneuver ) . Patients were r and omized to either the CRP ( n = 24 ) or a sham maneuver ( n = 26 ) . Measured outcomes included resolution of vertigo and positional nystagmus at follow-up examination . RESULTS The mean duration of follow-up was 10 days for both groups . Resolution of symptoms was reported by 12 ( 50 % ) of the 24 patients in the CRP group and by 5 ( 19 % ) of the 26 patients in the sham group ( P = .02 ) . The results of the Dix-Hallpike maneuver were negative for positional nystagmus in 16 ( 67 % ) of 24 patients in the CRP group and in 10 ( 38 % ) of 26 patients in the sham group ( P = .046 ) . CONCLUSION The CRP is effective treatment of benign paroxysmal positional vertigo , and this procedure can be performed by general internists on out patients with this disorder Objective . To evaluate the effectiveness of a canalith-repositioning procedure in postural control of older patients with idiopathic benign paroxysmal positional vertigo ( BPPV ) . Study Design . Prospect i ve clinical trial . Setting . A tertiary referral center . Methods . A 9-month follow-up survey with a prospect i ve design was conducted among 33 older patients with BPPV . Patients underwent static posturography ( Balance Rehabilitation Unit [ BRU ] ) and were administered the  Dizziness H and icap Inventory ( DHI ) before and after the maneuver . After the treatment , they were compared with 33 healthy older subjects . The posturography parameters were the limit of stability ( LOS ) , the center of body-pressure area ( COP ) , and the velocity of oscillation ( VOS ) under conditions of visual , somatosensory , and visual-vestibular conflict . Results . One canalith-repositioning procedure relieved most patients ’ complaints ( 54.5 % ) , and 100 % were relieved with 1 to 3 maneuvers . Total DHI score and all subscales improved after treatment ( P < .01 ) . The LOS values pretreatment ( mean [ SD ] 134.27 [ 55.32 ] cm2 ) and posttreatment ( 181.03 [ 47.79 ] cm2 ) were significantly different ( P < .01 ) . Comparative analysis of COP values showed a relevant statistical difference in 8 of 10 postmaneuver conditions ( P < .01 ) . The postmaneuver VOS showed a significant difference under 7 conflict conditions . There were no differences between the healthy older subjects and treated patients for all VOS values under all conditions and for COP values under 9 conditions . Conclusion . The canalith-repositioning procedure promotes remission of symptoms , an increase in LOS , and improvement in postural control under conditions of somatosensory and visual conflict and visual-vestibular interaction PURPOSE A single blinded prospect i ve r and omized controlled trial was conducted in 40 patients with benign paroxysmal positional vertigo ( BPPV ) to determine the efficacy of particle repositioning maneuver ( PRM ) . MATERIAL S AND METHODS Out of 40 patients , 20 underwent PRM  with the rest receiving a placebo treatment . Postprocedural instructions were given to all the patients who underwent PRM . Follow-up was for 1 year at regular intervals . Analysis was based on the symptomatic status and the Hallpike maneuver at each visit . RESULTS After the initial week , 95 % showed complete resolution of symptoms with none reporting a recurrence after PRM . On the contrary , only 15 % of the controls had complete resolution with 14 out of 20 reporting a recurrence of BPPV . Results remained more or less the same at the end of 4 weeks . Six months after PRM , 19 of 20 patients had no vertigo with a meager 5 % showing recurrence versus 75 % of controls reporting a recurrence with only 3 of 20 reporting a favorable symptom status . At the end of 1 year , 18 of 20 patients had complete relief from symptoms with only 10 % showing Hallpike maneuver positive in the study group compared with 3 of 20 reporting a relief from symptoms with 90 % turning out to be Hallpike maneuver positive in the control group . CONCLUSIONS This study establishes the efficacy of PRM in short- and long-term management of BPPV ; the procedure is easy and simple UNLABELLED The effectiveness of postmaneuver postural restrictions is controversial in patients with benign paroxysmal positional vertigo . AIM To verify the role of postural restrictions in patients with benign paroxysmal positional vertigo of posterior canal , su bmi tted to a single Epley maneuver . STUDY DESIGN clinical prospect i ve . MATERIAL AND METHOD Fifty eight patients with benign paroxysmal positional vertigo of posterior canal were r and omly divided in two groups following the application of a unique Epley maneuver . The patients from group 1 were informed to restrict their head movements and to use a cervical collar and group 2 patients were not informed about these postmaneuver restrictions . The patients from both groups were reevaluated one week after Epley maneuver , regarding the presence of symptoms and positional nystagmus . RESULTS One week after Epley maneuver 82.1 % of the patients from group 1 and 73.3 % from group 2 did n't present positional nystagmus ( p=0.421 ) . There was a clinical improvement in 96.0 % of the patients from group 1 and in 94.0 % from group 2 ( p=0.781 ) . CONCLUSION The use of postural restrictions in patients with benign paroxysmal positional vertigo of posterior canal did n't interfere in their clinical evaluation , one week after a unique Epley maneuver OBJECTIVE To determine to what extent patients with vestibular hypofunction experience falls . STUDY DESIGN Prospect i ve clinical study . SETTING Outpatient tertiary care facility in a university . PATIENTS Patients with unilateral ( n = 70 ) and bilateral ( n = 45 ) vestibular hypofunction , confirmed on vestibular function testing , aged 24 to 89 years . INTERVENTION None . MAIN OUTCOME MEASURE Incidence of falls . RESULTS There was a significant difference in the incidence of falls reported since the onset of the vestibular deficit by patients with unilateral ( UVL ) and bilateral ( BVL ) vestibular hypofunction . The incidence of falls for BVL was significantly greater than that for UVL . The incidence of falls for UVL was not different from that expected in a community-based population when age was considered . The incidence of falls for BVL was significantly greater than that reported for the general population aged 65 through 74 years ( 51.1 % for BVL , 25 % for community-dwelling individuals ) but was significantly less than expected for persons aged > or = 75 years ( 18.2 % for BVL , 49 % for community-dwelling individuals ) . The lower incidence of falls in patients with BVL aged > or = 75 years may be related to the use of assistive devices and to a decrease in risky behavior . All patients with serious injury were from the UVL group , and all were > 65 years old . The incidence of fall-related injuries requiring medical attention among patients with UVL was similar to that in community-dwelling individuals . CONCLUSIONS Falls are an important consequence of bilateral vestibular hypofunction , and patients should be counseled about the increased risk of falling . Assistive devices should be considered , especially for persons aged > 65 years with BVL UNLABELLED Dizziness is a common complaint among older adults . AIM To identify the prevalence of dizziness and its related factors in a sample of community-dwelling older adults . METHODS A prospect i ve population -based study with a representative sample of older adults aged 65 years and over . A multidimensional question naire and a battery of measures were used for assessing physical function . RESULTS The prevalence of dizziness was 45 % . Vertigo was found in 70.4 % of older adults with dizziness and 43.8 % of them referred vertigo crises along life . A significant association was found between dizziness and female gender ( p=0.004 ) , memory difficulties complaints ( p=0.015 ) , bad health perception ( p=0.001 ) , depression ( p<0.0001 ) , five or more comorbidities ( p=0.021 ) , self-reported fatigue ( p<0.0001 ) , recurrent falls ( p=0.001 ) , excessive sleepiness ( p=0.003 ) , fear of falling ( p<0.0001 ) , left leg unipedal stance ( p=0.002 ) and Short Performance Physical Battery score ( p=0.009 ) . CONCLUSION Dizziness is a common complaint among older adults and it is associated with limiting clinical conditions , such as depression , fatigue , excessive sleepiness and impaired memory . It is highlighted the association between dizziness and recurrent falls , fear of falling and lower performance in physical function tests , which can restrict independence . These data suggest the importance of a multifactorial approach to dizziness in older adults
INTRODUCTION Benign Paroxysmal Positional Vertigo is highly prevalent in elderly people .
This condition is related to vertigo , hearing loss , tinnitus , poor balance , gait disturbance , and an increase in risk of falls , leading to postural changes and quality of life decreasing .
OBJECTIVE To evaluate the outcomes obtained by clinical trials on the effectiveness of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises in the treatment of Benign Paroxysmal Positional Vertigo in elderly .