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.

Post urography is a useful new tool to study the influence of vestibular diseases on balance.Aim: to compare the results from the Balance Rehabilitation Unit (BRU) static posturography in elderly patients with Benign Paroxysmal Positional Vertigo (BPPV), before and after Epley's maneuver.Materials and Methods: a prospective study of 20 elderly patients with a diagnosis of BPPV. The patients underwent static posturography and the limit of stability (LE) and ellipse area were measured. We also applied the Dizziness Handicap Inventory (DHI) questionnaire to study treatment effectiveness.Results: 80% were females, with a mean age of 68.15 years. After the maneuver, the LE increased significantly (p=0.001). The elliptical area of somatosensory, visual and vestibular conflicts (2,7,8,9 situations) in BRU and the DHI scores decreased significantly (p<0.05) after treatment.Conclusion: the study suggests that elderly patients with BPPV may present static postural control impairment and that the maneuver is effective for the remission of symptoms, to increase in the stability and improvement in postural control in situations of visual, somatosensory and vestibular conflicts. Braz J Otorhinolaryngol. 2010;76(5):623-9. ORIGINAL ARTICLE BJORL

Objective: Evaluate the influence of Benign Paroxysmal Positional Vertigo (BPPV) in the balance control of the elderly after Epley’s maneuver and understand whether a reposition maneuver is enough to recover balance control. Method: Prospective study of 33 elderly patients with vertical canal BPPV seen in a tertiary center. Dizziness Handicap Inventory (DHI) and static posturography were determined before and after Epley’s maneuver. The parameters of the Balance Rehabilitation Unit (BRU) static posturography analyzed were: the limit of stability (LOS) and body sway velocity (VOS). Results: The DHI total and the subscale scores improved ( P = .001) after the treatment in all aspects. There was statistically significant improvement of the LOS pre- and posttreatment ( P = .001). Eight of 10 visual-vestibular stimuli had statistically significant improvement after treatment: with eyes closed ( P = .001); over foam and eyes closed ( P = .002); saccadic stimulation ( P = . 043); horizontal optokinetic stimulation ( P = .015); 2 different verticaloptokinetic stimulations ( P = . 003, P = . 009); two different visual-vestibular stimulations ( P = .003, P = .047). The VOS showed statistical significance after treatment for eyes closed ( P = .001); on foam and eyes closed ( P = .005); horizontal optokinetic stimulus ( P = .042); vertical optokinetic stimulus ( P = .027); horizontal visual vestibular stimulus ( P = .002); vertical visual vestibular stimulus ( P = .018). Conclusion: Elderly patients with BPPV present impairment of static postural control in vestibular conflicts. The maneuver promotes remission of symptoms, increases the limit of stability, and improves the control of postural balance in the conditions of somatosensory, visual, and visual-vestibular conflicts.