Are Postural Restrictions Necessary for Management of Posterior Canal Benign Paroxysmal Positional Vertigo?

Abstract

In our experience, postural restrictions do not enhance the beneficial effect of the CRMs. They do not seem to have any protective role and therefore should not be recommended as an adjunct to the treatment of PSC BPPV.

Effect of a Hybrid Maneuver in Treating Posterior Canal Benign Paroxysmal Positional Vertigo

“…The results of our study are not surprising, as they are more or less in accordance with the current literature. Our findings agree with most of the previous studies (DeBoodt, 2003;Radtke et al, 2004;Roberts et al, 2005;Fyrmpas et al, 2009;De Stefano et al, 2011;Papacharalampous et al, 2012;Toupet et al, 2012) that investigated the efficacy of postural restrictions on the success rate of CRM and reported that these restrictions do not influence resolution of BPPV. In addition, most of the patients in the restricted groups expressed a serious sense of discomfort.…”

“…In addition, there are contradictory reviews on the need for involvement of postmaneuver restrictions as a part of the treatment protocol for BPPV (Fyrmpas et al, 2009;De Stefano et al, 2011;Papacharalampous et al, 2012), which are used in an effort to prevent the otoconial debris from returning to the semicircular canals after treatment. Cakır et al (2006) and McGinnis et al (2009) stated positive outcomes for these restrictions.…”

“…Cakır et al (2006) and McGinnis et al (2009) stated positive outcomes for these restrictions. On the other hand, DeBoodt (2003), Radtke et al (2004), Roberts et al (2005), and De Stefano et al (2011) reported that these restrictions are not necessary because they do not enhance the beneficial effect of the maneuver. Therefore, we compared the effectiveness of the GRM and CRM on treatment of BPPV of the posterior canal (PC-BPPV), in addition to investigating the contribution of postmaneuver restrictions on treatment.…”

Effect of Repositioning Maneuver Type and Postmaneuver Restrictions on Vertigo and Dizziness in Benign Positional Paroxysmal Vertigo

“…Studies on their efficacy are contradictory [10, 14–17]. Several studies had methodological limitations: not randomized [16] or vertigo only evaluated by interrogation [14, 15, 17].…”

Understanding benign paroxysmal positional vertigo: the management of lateral canal involvement

“…28 We found that postural restrictions do not enhance the beneficial effects of physical treatment with manoeuvres. 29 There is no statistical evidence that restrictions have any role in preventing recurrences, but they often cause neck stiffness, so for these reasons, we do not recommend any restriction to our patients.…”