Frontiers in Rehabilitation Sciences (08/17/23) Vol. 4 Harrell, Regan G.; Hart, Rebecca; Jen, Joanna C.; et al.
A recent study evaluated the physical therapy community’s understanding of various forms of Benign Paroxysmal Positional Vertigo (BPPV). They collected data at a national professional meeting and a professional continuing medical education course for advancing vestibular rehabilitation competence. The survey explored therapists' treatment of BPPV patients; three clinical cases for definite BPPV, subjective BPPV and BPPV with vestibular agnosia; and demographic data. A total of 426 respondents completed the survey, with 364 indicating they had treated BBPV in practice for an average of 11 years. These respondents hailed from clinical practice settings including academia, acute care, home health, inpatient rehabilitation, outpatient neurological/vestibular, outpatient orthopedic, skilled nursing, sports and students. For the first clinical vignette, which was designed to assess respondents' understanding of definite BPPV, 62% of the respondents said they would always evaluate patients based on their reports of experiencing "room spinning" vertigo from head movement. Only 43% said they would perform positional testing to reevaluate when patients indicated persistent "lightheadedness or feelings of imbalance" from head movement. Fifty-one percent diagnosed definite BBPV in patients with subjective BPPV and 85% diagnosed the condition among patients with vestibular agnosia. "Our study only analyzed physical therapists' understanding of definite BPPV and the relatively recently described variants with more subtle presentation to demonstrate that there is a gap in knowledge regarding BPPV," the researchers wrote. They suggest additional training for BPPV diagnosis and management in the physical therapy curriculum and greater availability of vestibular-specific post-licensure continuing education courses across clinical areas and expertise. Also proposed is more collaboration and dialogue between referring doctors and physical therapists.