ROLE OF MODIFIED EPLEY’S MANEUVER AND BRANDT-DAROFF EXERCISES IN TREATMENT OF POSTERIOR CANAL BPPV: A COMPARATIVE STUDY

Background: Benign paroxysmal positional vertigo (BPPV) defined by Dix and Hallpike is one of the most common disorders causing vertigo. BPPV is more prevalent in adults and in women. BPPV mostly develops in the posterior semicircular canal. The main symptom of BPPV is vertigo induced by a change in head position with respect to gravity. The Dix-Hallpike test is the most commonly used test to confirm the diagnosis of posterior canal BPPV. Treatment options for posterior canal BPPV are Epley's maneuver, Liberatory maneuver and Brandt-Daroff exercises. In modified epley’s maneuver few modifications were done in original epley’s maneuver without affecting outcome. Objective: To assess effectiveness of modified epley’s maneuver as well as combination of modified epley’s maneuver with Brandt-Daroff exercise in patients with posterior canal BPPV and to compare both treatment protocols. Methodology: All patients were examined by Dix-Hallpike test (D-H Test) and those suffering from posterior canal BPPV and fulfilling inclusion criteria were taken up for the study. Total thirty five patients took part in this study on a voluntary basis after signing consent form. The patients were randomly assigned to two groups. In group 1, combination of modified epley’s maneuver and Brandt-Daroff exercise were given and in group 2 only modified epley’s maneuver was given. All patients were reexamined after 1 week of treatment and were asked to come for follow up after 1 month. In follow up visits response to Dix ? Hallpike maneuver and Dizziness Handicap Inventory(DHI) were assessed as outcome measures. Result: Data collected through this study showed highly significant improvement in DHI score and response to D-H test when intragroup comparison is made in both the groups after 1 week and 1 month of treatment at 1% level of significance. When intergroup comparison is made we found better improvement in group 2 after 1 week and in group 1 after 1 month of treatment. Conclusion: The conclusion of the study is that both treatment approaches are effective in reducing symptoms and improving independence level but combined approaches can give better result.