[The necessity of post-maneuver postural restriction in treating posterior canal benign paroxysmal positional vertigo: a Meta-analytic study]

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jun 7;56(6):603-612. doi: 10.3760/cma.j.cn115330-20201229-00957.
[Article in Chinese]

Abstract

Objective: We conducted a Meta-analysis to investigate the necessity of postural restrictions after manual reduction in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV). Methods: We searched PubMed, EBSCO, Proquest, Web of Science databases, Ovid, and screened eligible studies that investigated the effect of post-maneuver postural restriction in treating patients with PC-BPPV. Outcomes included the efficacy of treatment and recurrence. Meta-analysis was performed using Stata 15.0 software. Results: Studies of the single visit efficiency included 11 references, with a sample size of 1 733 cases. The Meta-analysis results showed that the difference in the efficacy between the postural restricted group and the non-postural restricted group in PC-BPPV patients was statistically significant(RR=1.12, 95%CI=1.07-1.18, P<0.001). There were 12 references included in the study on the total efficiency, with a cumulative sample size of 1763 cases. There was no statistically significant difference between the effect of postural restriction after manipulative reduction and that of simple manipulative reduction (RR=1.03, 95%CI=0.99-1.08, P=0.118). There were 5 references included in the study of recurrence rate, and the cumulative sample size was 659 cases. There was no statistically significant difference in the recurrence rate between the postural restricted group and the non-postural restricted group(RR=0.98, 95%CI=0.62-1.54, P=0.937). Conclusions: In comparison with non-postural restriction group, post-maneuver postural restriction after a single visit can improve the treatment effective rate of PC-BPPV and contribute to the improvement in the symptoms of patients in a short term. However, postural restrictions has no significant effect on the final prognosis of PC-BPPV, and it also has no significant effect on the recurrence.

目的: 应用Meta分析的方法探讨后半规管良性阵发性位置性眩晕(posterior canal benign paroxysmal positional vertigo,PC-BPPV)手法复位后体位限制的必要性。 方法: 计算机检索英文数据库PubMed、EBSCO、Proquest、Web of science及Ovid,筛选手法复位后体位限制对PC-BPPV患者疗效研究的相关文献,以有效率和复发率为疗效指标,采用Stata15.0软件对纳入文献进行Meta分析。 结果: 单次就诊有效性研究纳入文献11篇,累计样本量1 733例,Meta分析结果表明,PC-BPPV患者手法复位后进行体位限制与单纯手法复位疗效比较,差异有统计学意义(RR=1.12,95%CI=1.07~1.18,P<0.001)。总有效性研究纳入文献12篇,累计样本量1 763例,体位限制组与非体位限制组疗效比较,差异无统计学意义(RR=1.03,95%CI=0.99~1.08,P=0.118)。复发率研究纳入文献5篇,累计样本量659例,体位限制组与非体位限制组复发率比较,差异无统计学意义(RR=0.98,95%CI=0.62~1.54,P=0.937)。 结论: 与非体位限制组相比,单次就诊手法复位后进行体位限制可能有助于提高PC-BPPV治疗的有效率,而在不考虑就诊次数情况下,是否进行体位限制对PC-BPPV的最终预后无显著影响,是否进行体位限制对日后复发亦无明显影响。.

Publication types

  • Meta-Analysis

MeSH terms

  • Benign Paroxysmal Positional Vertigo* / therapy
  • Environment
  • Humans
  • Patient Positioning*
  • Recurrence
  • Semicircular Canals
  • Treatment Outcome