Research Letter: Rate of BPPV in Patients Diagnosed With Concussion

Abstract

Objective: The purpose of this study was to investigate the incidence of benign paroxysmal positional vertigo (BPPV) specifically among patients with dizziness in the rehabilitation phase of concussion recovery and to provide evidence regarding the importance of BPPV assessment in physical therapy concussion evaluations. Setting: Outpatient neurologic rehabilitation center at a suburban comprehensive rehabilitation hospital. Participants: Fifty patients diagnosed with concussion and referred to vestibular physical therapy with complaints of dizziness were tested for BPPV within their first 3 visits. Design: In this prospective cohort study, a positive Dix-Hallpike test or Horizontal Roll test indicated the presence of BPPV. Main Measures: The primary outcome measure was the presence of BPPV. Additional demographic and injury-specific variables were also considered. Among secondary outcomes, patient characteristics and Dizziness Handicap Inventory scores were compared on the basis of presence or absence of BPPV. Results: Eleven participants, 22%, tested positive for BPPV. Only fall, as the mechanism of injury, was statistically significant (P < .05), with 72.7% of those who tested positive for BPPV reporting having been injured in a fall compared with 30.8% in the negative group. Nearly half, 45%, of the participants who were positive for BPPV had resolution of their BPPV within 1 visit. Conclusion: This study is unique in its focus on mild traumatic brain injury in the rehabilitation phase of recovery. The results provide evidence regarding the importance of BPPV assessment in physical therapy concussion evaluations.