Effectiveness of Epley–Canalith Repositioning Procedure versus Vestibular Rehabilitation Therapy in Diabetic Patients with Posterior Benign Paroxysmal Positional Vertigo: A Randomized Trial

Abstract

Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder, characterized by brief episodes of vertigo caused by changes in head position. The condition can cause significant functional impairment and reduced quality of life. BPPV is especially common among diabetic patients. The Epley–canalith repositioning procedure (CRP) and vestibular rehabilitation therapy (VRT) are two commonly used interventions for the treatment of BPPV. The objective of this study is to compare the effectiveness of Epley–canalith repositioning procedure (ECRP) and Vestibular Rehabilitation (VR) therapy in the management of vertigo among Type 2 Diabetes Mellitus patients. A total of 30 subjects with Type 2 diabetes mellitus, aged between 40 and 65 years, were randomly allocated to either the ECRP or VR therapy groups using a lottery method, and then underwent Epley–canalith repositioning procedure or vestibular rehabilitation therapy, respectively. The outcomes measured by the study were Vertigo Symptom Scale–Short Form (VSS–sf) score and Berg Balance Scale (BBS) score, assessed pre-treatment (pre) and 4 weeks post-treatment (post). The results demonstrated that both ECRP and VR therapy led to improvements in VSS–sf and BBS scores. However, VR therapy was found to be more effective, resulting in a 13.6% higher improvement in VSS–sf scores (p = 0.03) and a 5.1% higher improvement in BBS scores (p = 0.51) compared to ECRP. Both Epley–canalith repositioning procedure and vestibular rehabilitation therapy are effective in managing BPPV in diabetic patients. Although the differences in BBS scores are not statistically significant, VRT demonstrated a trend towards greater improvement. Vestibular rehabilitation therapy can be used by clinicians as another rehabilitation technique for improving vertigo, postural stability, and activity of daily living in diabetic patients with BPPV.