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Objective: Benign Paroxysmal Positional Vertigo is a vestibular disorder causing vertigo and imbalance. This systematic review and meta-analysis aims to explore the impact of benign paroxysmal positioning vertigo and repositioning maneuvers on postural control. Data Sources: In September 2024, PubMed, Web of Science, Scopus and reference lists of included studies were systematically searched. Articles comparing measures of postural control between patients and controls, and/or pre- and posttreatment were considered relevant. Methods: Study selection, data extraction and identification of risk of bias were done by two researchers. If possible, meta-analysis was performed with Review Manager version 5.4.1 and standardized mean differences were calculated with a random-effects model. Results: Twenty-one of the 37 included studies were useful for meta-analyses. Meta-analyses revealed that benign paroxysmal positional vertigo negatively affects perception of verticality (p <.001; SMD = 0.73; 95% CI = [0.39;1.08]) and sensory orientation (p <.001; SMD = −1.66; 95% CI = [−2.08, −1.23]). The perception of verticality (p <.001; SMD = 0.99; 95% CI = [0.76;1.21]) and sensory orientation (p <.001; SMD = −0.77; 95% CI = [−1.11, −0.44]) improved after treatment with repositioning maneuvers. Results of systematic review indicate stability in gait was impaired, vertigo but improve after repositioning maneuvers. Limits of stability were impaired in older patients, but did not improved after repositioning maneuvers. Conclusion: Benign paroxysmal positioning vertigo affects several underlying components of postural control. Repositioning maneuvers can significantly improve the related postural control impairments. This may partly explain the increased odds of falling in these patients, and the positive treatment effect of repositioning maneuvers on falls and fear of falling. [ABSTRACT FROM AUTHOR]

Background/Objectives: Benign Paroxysmal Positioning Vertigo (BPPV), diagnosed in 46% of older adults with complaints of dizziness, causes movement-related vertigo. This case-control study compared physical activity, frailty and subjective well-being between older adults with BPPV (oaBPPV) and controls. Methods: Thirty-seven oaBPPV (mean age 73.13 (4.8)) were compared to 22 matched controls (mean age 73.5 (4.5)). Physical activity was measured using the MOX accelerometer and the International Physical Activity Questionnaire. Modified Fried criteria assessed frailty. The Dizziness Handicap Inventory, Falls Efficacy Scale, and 15-item Geriatric Depression Scale assessed subjective well-being. A post-hoc sub-analysis compared all variables compared between frail oaBPPV, robust oaBPPV and robust controls. Significance level was set at α = 0.05. Results: oaBPPV were significantly less physically active and were more (pre-)frail (p < 0.001) compared to controls. They performed significantly less active bouts (p = 0.002) and more sedentary bouts (p = 0.002), and a significantly different pattern of physical activity during the day. OaBPPV reported significantly less time in transportation activities (p = 0.003), leisure (p < 0.001), walking (p < 0.001) and moderate-intensity activities (p = 0.004) compared to controls. Frail oaBPPV were even less active (p = 0.01) and experienced more fear of falling (p < 0.001) and feelings of depression (p < 0.001) than robust oaBPPV and controls. Conclusions: BPPV can induce a vicious cycle of fear of provoking symptoms, decreased physical activity, well-being and consequently frailty. It is also possible that frail and less physically active older adults have an increased prevalence of BPPV. Post-treatment follow-up should assess BPPV, frailty and physical activity to determine if further rehabilitation is needed. [ABSTRACT FROM AUTHOR]

Background and Purpose: Even though Benign Paroxysmal Positioning Vertigo (BPPV) is one of the most reported vestibular disorders, its interaction with frailty and postural control in older adults is hardly or not investigated., Methods: Thirty-seven older adults (≥65 years) with a diagnosis of BPPV (oaBPPV) (mean age 73.13 (4.8)) were compared to 22 age-, weight-, and height-matched controls (mean age 73.5 (4.5)). Modified Fried criteria were used to assess frailty. Postural control was assessed with the timed chair stand test, mini Balance Systems Evaluation test (mini-BESTest), a Clinical Test of Sensory Interaction on Balance (CTSIB), and 10-m walk test. Falls were inquired. The Dizziness Handicap Inventory, Falls Efficacy Scale, and 15-item Geriatric Depression Scale assessed dizziness-related handicap, fear of falling, and feelings of depression, respectively. To assess the importance of frailty, all variables were also compared between frail oaBPPV, robust oaBPPV, and robust controls in a sub-analysis. The significance level was set at α = 0.05., Results: oaBPPV reported significantly more multiple falls ( P = 0.05) and difficulties to remain standing with increasing task difficulty of the CTSIB ( P = 0.004). They were significantly more (pre-)frail compared to controls ( P < 0.001). Moreover, frail oaBPPV had a significantly decreased reactive postural control ( P < 0.001) and dynamic gait ( P < 0.001). Their fear of falling ( P < 0.001) and dizziness-related handicap ( P < 0.001) were significantly higher compared to robust oaBPPV., Discussion and Conclusions: oaBPPV were less healthy and more (pre-)frail compared to controls, impacting their daily functioning. Future research should investigate whether frailty and postural control were already decreased before the BPPV onset and if this recovers after treatment with repositioning maneuvers or if additional rehabilitation is necessary., Impact Statement: Older adults with Benign Paroxysmal Positional Vertigo (BPPV) can present with an impaired sensory orientation, declined cognition, significantly more multiple falls, and (pre-)frailty compared to controls. Moreover, frail older adults with BPPV also had a significantly decreased reactive postural control and dynamic gait, and an increased odds of falling compared to robust controls. BPPV and frailty appear to be linked with each other, which cannot be ignored in future research and clinicians treating older adults with BPPV., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Academy of Neurologic Physical Therapy, APTA.)