TY - JOUR
T1 - Gait and Falls in Benign Paroxysmal Positional Vertigo
T2 - A Systematic Review and Meta-analysis
AU - Pauwels, Sara
AU - Casters, Laura
AU - Lemkens, Nele
AU - Lemmens, Winde
AU - Meijer, Kenneth
AU - Meyns, Pieter
AU - Van De Berg, Raymond
AU - Spildooren, Joke
N1 - Funding Information:
This study was supported by Maastricht University, ZOL Genk, and the Special Research Fund of the Hasselt University (BOF20OWB12).
Publisher Copyright:
© 2023 The Authors.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background and Purpose: Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders, and is treated effectively with particle repositioning maneuvers (PRM). The aim of this study was to assess the influence of BPPV and treatment effects of PRM on gait, falls, and fear of falling. Methods: Three databases and the reference lists of included articles were systematically searched for studies comparing gait and/or falls between (1) people with BPPV (pwBPPV) and controls and (2) pre- and posttreatment with PRM. The Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Results: Twenty of the 25 included studies were suitable for meta-analysis. Quality assessment resulted in 2 studies with high risk of bias, 13 with moderate risk, and 10 with low risk. PwBPPV walked slower and demonstrated more sway during tandem walking compared with controls. PwBPPV also walked slower during head rotations. After PRM, gait velocity during level walking increased significantly, and gait became safer according to gait assessment scales. Impairments during tandem walking and walking with head rotations did not improve. The number of fallers was significantly higher for pwBPPV than for controls. After treatment, the number of falls, number of pwBPPV who fell, and fear of falling decreased. Discussion and Conclusions: BPPV increases the odds of falls and negatively impacts spatiotemporal parameters of gait. PRM improves falls, fear of falling, and gait during level walking. Additional rehabilitation might be necessary to improve gait while walking with head movements or tandem walking.
AB - Background and Purpose: Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders, and is treated effectively with particle repositioning maneuvers (PRM). The aim of this study was to assess the influence of BPPV and treatment effects of PRM on gait, falls, and fear of falling. Methods: Three databases and the reference lists of included articles were systematically searched for studies comparing gait and/or falls between (1) people with BPPV (pwBPPV) and controls and (2) pre- and posttreatment with PRM. The Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Results: Twenty of the 25 included studies were suitable for meta-analysis. Quality assessment resulted in 2 studies with high risk of bias, 13 with moderate risk, and 10 with low risk. PwBPPV walked slower and demonstrated more sway during tandem walking compared with controls. PwBPPV also walked slower during head rotations. After PRM, gait velocity during level walking increased significantly, and gait became safer according to gait assessment scales. Impairments during tandem walking and walking with head rotations did not improve. The number of fallers was significantly higher for pwBPPV than for controls. After treatment, the number of falls, number of pwBPPV who fell, and fear of falling decreased. Discussion and Conclusions: BPPV increases the odds of falls and negatively impacts spatiotemporal parameters of gait. PRM improves falls, fear of falling, and gait during level walking. Additional rehabilitation might be necessary to improve gait while walking with head movements or tandem walking.
KW - benign paroxysmal positional vertigo
KW - falls
KW - fear of falling
KW - gait
KW - repositioning maneuver
U2 - 10.1097/NPT.0000000000000438
DO - 10.1097/NPT.0000000000000438
M3 - (Systematic) Review article
C2 - 36897200
SN - 1557-0576
VL - 47
SP - 127
EP - 138
JO - Journal of Neurologic Physical Therapy
JF - Journal of Neurologic Physical Therapy
IS - 3
ER -