Physical therapy for benign paroxysmal positional vertigo patients with movement disability

Objective: Particle repositioning manoeuvres are broadly recognized effective for benign paroxysmal positional vertigo (BPPV), however, we think that these therapies are not suitable for all BPPV patients. In this study we investigate whether these manoeuvres can be used for BPPV patients with the movement disability. In addition, we introduce our habituation training (HT) and report the results of treatment with it. Methods: Nine BPPV patients with the movement disability due to orthopedic disease were examined. For each patient we determined their movement disabilities, and assessed the suitability of particle repositioning manoeuvres, Brandt–Daroff (B–D) manoeuvre and HT for them. Results: All of these nine patients had neck or trunk movement disabilities due to orthopedic disease, and we judged that particle repositioning manoeuvres and B–D manoeuvre were impossible or too risky to be employed in them. Although HT was suitable for them and symptoms and signs of them improved within a short period of time. Conclusion: Particle repositioning manoeuvres were not suitable for BPPV patients with the movement disability because these manoeuvres required various movements. These patients were able to perform HT depending on their capabilities. We think that HT is caused by the fatigability of BPPV, and it accelerates the natural curing process.