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Title: EFFECT OF MODIFIED EPLEY’S & SEMONT’S MANEUVERS WITH OR WITHOUT BETA-HISTINE ON BENIGN PAROXYSMAL POSITIONAL VERTIGO: A RANDOMIZED CONTROL TRAIL
Authors: Muhammad Salman, Muhammad Umar, Mazhar Badshah, Aamer Naeem
Journal: The Rehabilitation Journal
Publisher: Human Easement Foundation
Country: Pakistan
Year: 2022
Volume: 6
Issue: 2
Language: English
Background: Benign Paroxysmal Positional Vertigo (BPPV) is a condition related to vestibular system accompanied by dizziness, tinnitus and balance problems leading to increased fall risk and potential disability. Various treatment options are available including pharmacotherapy and vestibular rehabilitation with varied results. Objective: To compare the efficacy of Modified Epley and Semont’s manoeuvre with and without Beta-histine for BPPV. Methodology: A single blinded Randomized control trail, registered at clinicaltrial.gov under clinical trial registry NCT05309538, was conducted on n=90 patient having Benign Paroxysmal Positional Vertigo; at the Neurocouncil Hospital & the physiotherapy clinic. from June 2021- August 2021. The participants between 18 to 60 years with positive modified Dix Hil pike test were included in the study. The n=90 participants were equally divided via lottery method into Group A and B, Both group received mEpley’s and Semont’s Manoeuvres, Group B additionally received beta-histine. The dizziness handicapped inventory and EQ-5D-5L questionnaire were used for dizziness and quality of life respectively. The data were collected at the baseline and at the end of 4th week. The data was analyzed with SPSS version 21. Results: The wilcoxon rank test showed that there was significant improvement (p<0.001) in dizziness handicapped inventory, all domains and the total score of EQ-5D quality of life questionnaire. While comparing both groups no significant (p≥0.05) additional effects of Betahistine with modified Epley’s and Semont’s manoeuvres on dizziness handicapped inventory and quality of life. Conclusion: The study concluded that the Betahistine has no additional effects in the management dizziness of BPPV
Keywords: Disability, psychological Adjustment, Stress BPPV, Modified Epley’s manoeuvre, Semont’s manoeuvre, vertigo, dizziness, quality of life.
To compare the efficacy of Modified Epley and Semont's manoeuvre with and without Beta-histine for Benign Paroxysmal Positional Vertigo (BPPV).
A single-blinded Randomized Control Trial (RCT) involving 90 patients diagnosed with BPPV. Participants were equally divided into two groups. Both groups received modified Epley's and Semont's manoeuvres. Group B additionally received beta-histine. Dizziness Handicap Inventory (DHI) and EQ-5D-5L questionnaires were used to assess dizziness and quality of life at baseline and after 4 weeks. Data was analyzed using SPSS version 21, with Wilcoxon Rank test for within-group analysis and Mann Whitney U test for between-group analysis.
graph TD
A["Patient Recruitment n=90 BPPV patients"] --> B["Random Allocation"];
B --> C["Group A: Modified Epley's & Semont's Manoeuvres"];
B --> D["Group B: Modified Epley's & Semont's Manoeuvres + Beta-histine"];
C --> E["Baseline Assessment DHI, EQ-5D-5L"];
D --> E;
E --> F["Intervention 2 weeks"];
F --> G["Post-Intervention Assessment DHI, EQ-5D-5L"];
G --> H["Data Analysis SPSS v21"];
H --> I["Conclusion"];
The study supports the effectiveness of positioning manoeuvres (Modified Epley's and Semont's) in reducing BPPV symptoms and improving quality of life. The findings suggest that beta-histine does not provide a significant additional benefit when used in conjunction with these manoeuvres for BPPV management. Previous studies on positioning manoeuvres also show significant improvements, and some studies suggest beta-histine might aid postural stability or be more effective in early stages of BPPV, but this study did not find such an effect.
Both treatment approaches (manoeuvres with and without beta-histine) showed significant improvement in dizziness and quality of life (p<0.001). There was no significant additional effect of beta-histine when combined with the manoeuvres on dizziness or quality of life (p>0.05).
Positioning manoeuvres, including liberatory manoeuvres, are effective in improving the quality of life and DHI scores for patients with BPPV, and can be adopted without pharmacological intervention.
1. Number of Participants: The study included n=90 patients with BPPV.
2. Intervention Duration: Participants received treatment for two weeks.
3. Statistical Significance: A p-value of less than 0.001 indicated significant improvement within groups.
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