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document
Systematic approach to benign paroxysmal positional vertigo in the elderly . OBJECTIVE We evaluated the effectiveness of a management approach that combines the canalith repositioning maneuver ( CRM ) and vestibular rehabilitation ( VR ) in the treatment of benign positional paroxysmal vertigo ( BPPV ) in elderly persons . STUDY DESIGN AND SETTING Forty-seven patients ( > /=70 years old ) with the diagnosis of unilateral posterior semicircular canal BPPV formed the study population . This study has 2 parts . In the first part , patients were randomly assigned to 1 of 2 groups : the CRM and avoidance ( no treatment ) . Patients were evaluated 1 month after the first visit . Those patients not responding to treatment were enrolled in the second part of the study , treated with an individualized combination of CRM and VR , and then reevaluated 3 months later . RESULTS Statistically significant improvement of vertigo and provoked nystagmus in 64 % of patients in the CRM group compared with the no-treatment group . After the addition of VR , 77 % of all patients improved . CONCLUSION A combination of CRM and VR improves BPPV in the elderly . SIGNIFICANCE These findings suggest that although CRM is more effective than no treatment , VR can be added to improve the results in the treatment of BPPV .
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Intervention_Physical
Systematic approach
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Intervention_Physical
canalith repositioning maneuver ( CRM ) and vestibular rehabilitation ( VR )
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Intervention_Control
CRM and avoidance ( no treatment )
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Intervention_Physical
an individualized combination of CRM and VR
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Outcome_Physical
vertigo
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Outcome_Physical
provoked nystagmus
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Outcome_Physical
VR
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Outcome_Physical
BPPV