Investigation of the kinematics and proprioception in patients with benign paroxysmal positional vertigo compared to healthy controls: a cross-sectional study.

PURPOSE: This study aimed to investigate changes in cervical kinematics and proprioception in patients with history of recurrent idiopathic posterior canal benign paroxysmal positional vertigo (BPPV) compared to healthy controls.

METHOD: This was a cross-sectional study comparing patients with BPPV (cases) to healthy controls that was done at Orthopedic and Rehabilitation Research Center. Twenty-five patients with idiopathic posterior canal BPPV (41.08 ± 8.89 years) and 27 age-matched healthy controls (37.37 ± 7.31 years). Posterior canal BPPV confirmed by Dix-Hallpike maneuver, in subjects who last more than two weeks since the last of their vertigo episode, with Tampa Scale for Kinesiophobia (TSK) score < 37. Cervical kinematics (range of motion) were measured using synchronized electrogoniometer systems, while proprioception was assessed via laser-based joint position error testing. Data were analyzed using independent t-tests (normal distribution) and Mann-Whitney U tests (non-parametric data), with significance at p < 0.05.

RESULTS

Twenty-five BPPV patients and 27 controls completed the study. BPPV patients had significantly lower maximum neck extension (28.32°±19.44° vs. 46.52°±23.05°, p = 0.004), flexion (21.01°±7.9° vs. 30.05°±9.12°, p < 0.0001), lateral bending to left (22.62°±6.27° vs. 32.22°±10.6°, p < 0.0001) and right (23.36°±8.31° vs. 29.66°±10.55°, p = 0.023). No significant differences were observed in rotation ROM (p > 0.05). Joint position error was significantly higher in the BPPV group for all directions (flexion, extension, right/left rotation; p < 0.0001).Furthermore, peak movement velocity was reduced in the BPPV group in the sagittal (16 ± 8 deg/s vs. 26 ± 11 deg/s, p < 0.0001) and frontal planes (17 ± 6 deg/s vs. 24 ± 7 deg/s, p = 0.001).

CONCLUSION

It seems that patients with BPPV would have greater kinematic and proprioceptive deficits. These findings highlight a significant association between cervical musculoskeletal dysfunction and BPPV. The cross-sectional nature of this study cannot determine causality; therefore, future longitudinal or cohort studies are essential to investigate the temporal and potential causative relationship between these variables.