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Shahanawaz and Rathod URJMS 2015, 02 (04): Page 8-10

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Research Article
ISSN 2395-4183
2395
UNIVERSAL RESEARCH JOURNAL OF MEDICAL SCIENCES
Available online: www.ujponline.com

TO DEVELOP AND VALIDATE MULTI COMPONENT EXERCISE PROGRAMME
ON DIZZINESS CAUSED BY BPPV PATIENTS
Shahanawaz SD*1, Rathod Priyanshu V2
1

PhD Scholar, School of Physiotherapy, RK University, Rajkot, Gujarat & Asst. Professor, Dr.DY.Patil College of Physiotherapy,, Dr.DY.Patil
Dr.D
Vidyapeeth, Pune, India
2
Director, School of Physiotherapy RK University, Rajkot, Gujarat, India

Received 28-06
06-2015; Revised 25-07-2015; Accepted 22-08-2015
*Corresponding Author: Shahanawaz SD
PhD Scholar School of Physi
Physiotherapy, RK University, Rajkot, Gujarat, India, Mobile: +91 9561551234

ABSTRACT
Background of the study: In BPPV the patient was having dizziness and it also loss the balance it may be because of primary sensory
information is the visual system vestibular input work together with visual and somato sensory system to maintain postural
postur control
(Merla and Spaulding, 1997). In BPPV studies it was also observed that dizziness and balance was effected but the previous studies
are focusing the specific exercise maneuverers like brandt daro exerc
exercises, cawthrone exercises ,ocular and vestibular components .
Objective of the study: To develop the multi component exercise programmes and validate
Methodology: Content validity was judged by the panel of raters on the relevance of the T test items to the
t representativeness of
interventional exercises for BPPV. The 21-items
items with 21 questions pertaining to the major problem in BPPV was used to assess.
assess The
study was ethically approved by the Dr. D.Y. Patil Vidyapeeth, Pune .And before all consent was taken .The questionnaire (exercises)
was a 21-item
item based on retrospective studies of the vestibular rehabilitation and previous clinical experiences of the clinicians.
Results: Validity is applied to a test with judgment concerning how well a test does measure what ìt purports to measure. More
specifically, it is a judgment based on evidence about the appropriateness of inferences drawn from test scores. Validation is the
process of gathering and evaluating valìdity evidence.
Keywords: Validity, Exercise Programme, Dizziness, BPPV, Multi component, Item.

INTRODUCTION
BPPV is one of the most common causes vertigo .Dizziness
arises when orientation in the space is disturbed knowing
where the body is in relation to the environment and being
able to move efficiently dizzy requires the integration
tegration of as set
of delicate sensing devices (i.e proprioception, visual,
vestibular) that feed information about the environment and a
motor system1.
In BPPV the patient was having dizziness and it also loss the
balance it may be because of primary sensory information is
the visual system vestibular input work together with visual
and somato sensory system to maintain postural control
(Merla and Spaulding, 1997). In BPPV studies it was also
observed that dizziness and balance was effected but the
previous studies are focusing the specific exercise
maneuverers like brandt daro exercises, cawthrone exercises
,ocular and vestibular components .
So this studyy was focusing to develop a multi component
protocol to validate it.
Objective of the study: To develop the multi component
exercise programmes and validate

METHODOLOGY
Content validity was judged by the panel of raters on the
relevance of the Test items to the representativeness of
interventional exercises for BPPV. The 21-items
21
With 21 questions pertaining to the major problem in BPPV
was used to assess.
The study was ethically approved by the Dr.D.Y.Patil
Vidyapeeth, Pune .And before all consent was taken
take .The
questionnaire (exercises) was a 21-item
21
based on retrospective
studies of the vestibular rehabilitation and previous clinical
experiences of the clinicians. lt consisted of items regarding
neck movements ,neck stretches, head rotations, imaginary
technique, occulomotor muscle movements, proprioceptive
loading, pertubations, lower
er limb strengthening exercises,
exercises
brisk walking, back strengthening, brisk walking. Items were
on Likert-type
type rating scale: "Essential", "Not Essential" for 2
sessions/day for 12 weeks .Where “Essential” score as 0 and “
Not Essential “ score was 1. All structured 21 items exercise
questionaries’ was thoroughly answered by the experienced
physical therapists ,and it took about 10-15
10
minutes to
complete. To help assess test--retest reliability, again few
experienced physical therapists were asked, by e mail, and

Universal Research Journal of Medical Sciences, 0
02 (04), July-August 2015
201

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Shahanawaz and Rathod URJMS 2015, 02 (04): Page 8-10
telephonic conversation to complete the questionnaire again at
one month after the first response.
We used the SPSS 15.0 version

RESULTS
Validity is applied to a test with judgment concerning how
well a test does measure what ìt purports to measure. More
specifically, it is a judgment based on evidence about the
appropriateness of inferences drawn from test scores.

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21

Validation is the process of gathering and evaluating validity
evidence15.
In the content validity the panel of raters were the experienced
clinical therapists rated each item .Total 21 items against each
item it was essential and not essential .The raters was to score
it and the obtained score of 21 items was assessed statistically
by using the Univariate analysis by Mann-Whitney U Test for
questions against Essential Not Essential groups at 0.05
significance level. As it was observed that 11 items were
qualified statistically and remaining 10 items was showing
statistical in –significant.

Table 1: Validate Exercise Protocol for Dizziness patients: BPPV
Items
Repetition
Time
straight head
3 times
30second
Turn your ahead 45 degrees towards right in sitting position
3 times
30 second
Turn your ahead 45 degrees towards left in sitting position
1 time
30second
Close your eyes and imagine blank back ground
1time
30second
Close Your Eyes Busy back ground (Checker Board)
1 time
30 second
Single Leg Stance -Right Side
1 time
30 second
Single Leg Stance - Left Side
1 time
30second
Heel and Toe raises
1 time
30 second
Perturbation training
1 time
30secomd
Hip marching
1 time
30 second
Lift up your right knee as high as comfortable. (Lower your leg, 10,lifts(each
30 second
Alternate lifting your knees)
leg)
Sit and straight your right knee
6 times
30second
Close the left eye and fix the right eye to object as it moves
30 seconds
Close the right eye
------30 seconds
Fix the eye to object as it moves
Brisk walking
1 time
1 Minute
Static quadriceps exercise
1 time
30 seconds
Static Hamstring exercise
1 time
30 seconds
Back strengthening
1 time
30 seconds
Neck isometrics
1 time
30 seconds
Neck stretching
1 time
30 times
Cervical gliding
1 time
30 times

Essential

Not essential

Table 2: Univariate analysis by Mann-Whitney U Test for questions against Essential Not Essential groups
Item No.
Items
p-value
1
Straight head
0.003
2
Turn your ahead 45 degrees towards right in sitting position
0.004
3
Turn your ahead 45 degrees towards left in sitting position
0.002
4
Close your eyes and imagine blank back ground
0.005
5
Close Your Eyes Busy back ground (Checker Board)
0.005
6
Single Leg Stance -Right Side
0.003
7
Single Leg Stance - Left Side
0.002
8
Heel and Toe raises
0.005
9
Perturbation training
0.005
10
Hip marching
0.032
Lift up your right knee as high as comfortable. (Lower your leg,
11
0.058
Alternate lifting your knees)
12
Sit and straight your right knee
0.063
13
Close the left eye and fix the right eye to object as it moves
0.002
14
Close the right eye
0.003
Fix the eye to object as it moves

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Shahanawaz and Rathod URJMS 2015, 02 (04): Page 8-10
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16
17
18
19
20
21

Brisk walking
Static quadriceps exercise
Static Hamstring exercise
Back strengthening
Neck isometrics
Neck stretching
Cervical gliding
5.

DISCUSSION
To our knowledge, this current study presented the first
attempt to develop and validate a multi component exercise
programme on dizziness in BPPV patients in Indians that can
be used for treatment purpose.
The 11 items which shows statistical significant were neck
movements, mental imaginary techniques, proprioception,
occulomotor exercises this is because was the dizziness caused
by BPPV having strong physiological connection with the
vestibular system
Kammerlind As et al 10 suggests that exercises for flexibility
,strengthening and balance exercises for 60 minutes with 8
weeks also help additional advantage in improving the
dizziness
Johansan M et al 11 was vestibular rehabilitation therapy with
behavioural therapy and also many studies suggest to addition
of exercises along with basic protocol

6.

7.

8.

9.

CONCLUSION
The validity supported the use of the multi component
exercise programme on dizziness in BPPV subjects. This
questionnaire was screened by expert clinical therapists 11
items out of 21 item have statistically qualified and appeared
to have high potential utility as a treatment tool.
Ethical Committee: Dr.D.Y.Patil VIdyapeeth (Pune)

10.

11.

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Source of support: Nil, Conflict of interest: None Declared

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