Effectiveness of Brandt-Daroff exercises in benign paroxysmal positional vertigo: a systematic review

Abstract

Introduction Benign Paroxysmal Positional Vertigo (BPPV) is defined as a disorder of the inner ear characterised by repeated episodes of positional vertigo. BPPV is one of the most prevalent vestibular disorders in the general population, accounting for one-third of all vestibular disorders. The prevalence of BPPV is higher in females than males and this prevalence increases with increasing age. The common non-surgical treatments of BPPV are repositioning manoeuvres and habituation exercises. This review aimed to explore the effectiveness of Brandt-Daroff exercises in patients with BPPV. Methods Two search engines, PubMed and Cochrane, were used. Articles focusing on Brandt-Daroff exercises as management of BPPV were included in this review. All articles were published in English and results up to February 2023 were included. Results Epley’s repositioning manoeuvre is a better treatment option for posterior canal BPPV. Epley’s manoeuvre is more effective if applied alone as compared to its application along with Brandt-Daroff exercises or with medication. Epley’s manoeuvre was more effective than any other repositioning manoeuvre, such as the Semontmanoeuvre. The application of Brandt-Daroff was ineffective when applied alone. However, it was effective when applied in combination with the Cawthorne-Cooksey exercises in reducing the symptoms of BPPV. Conclusions Brandt-Daroff exercises have inconsistent results in the treatment of BPPV; hence, high-quality randomised controlled trials should be carried out to investigate their efficacy.

Keywords

• benign paroxysmal positional vertigo
• vestibular diseases
• habituation
• rehabilitation