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Can You Train With Vertigo? The Spinning-Room Barbell Audit: The Population File Where 2.4% Carry BPPV but Only 8% Ever Received the Effective Treatment, the 12-Fold Fall Odds That Make a Loaded Spine the Wrong Place for an Active Spin, the Epley Ledger at 100% Resolution in the Original 30 With 71.5% After One Session and 91.4% Cumulative Pooled Today, the Cochrane That Ranks the Repositioning Maneuver Above Exercise for BPPV While Vestibular Rehab Owns the Chronic Tail, Recurrence Priced at 16% With Vitamin D and Calcium as the Testable Predictors and Head Trauma Running the Comeback at RR 3.39, and the Vestibular-Migraine/Ménière/PPPD Differential With a Metoprolol Null on Top — the Program That Treats the Maneuver as the Treatment and the Barbell as the Thing You Return To

By RightRep AI Assistant · · 22 min read

Vertigo is the diagnosis this library opens from the inner-ear side, and it is quietly one of the most common doors in the whole sweep: the nationally representative neurotological survey put benign paroxysmal positional vertigo at 2.4% lifetime prevalence, 1.6% one-year prevalence and 0.6% one-year incidence — attacks under a minute, provoked by head-position changes, with a median episode of two weeks — while 86% of affected people interrupted their lives for it and only 8% ever received effective treatment [1]. Widen the lens and it dwarfs most doors in this library: 35.4% of US adults aged 40 and older — 69 million Americans — had vestibular dysfunction on a simple standing-balance test, and those clinically symptomatic with it carried a 12-fold increase in the odds of falling [2]. This door answers the diagnosed lifter's version: what happens to a barbell program when the room spins on certain head positions, the treatment is a fifteen-minute movement procedure, and the main hazard is not tissue damage but a loaded spine meeting an active spin. The default scripts fail in opposite directions. The scared script shelves training for a spinning room that medicine already knows how to end — the canalith repositioning procedure resolved the positional vertigo and nystagmus in 100% of the original 30 patients [4], the clinical practice guideline makes it a strong recommendation [3], and modern pooling runs at 71.5% success after one session and 91.4% cumulative [6]. The reckless script loads the barbell mid-spin — with symptomatic vestibular dysfunction carrying 12× the odds of falling [2], the squat rack is the wrong laboratory for finding out whether this is the attack that stops in sixty seconds [1]. The reframe that carries the whole file: in vertigo the treatment is itself a movement protocol, the trigger is a position you can re-rig — and the barbell is the thing you return to, not the thing you hide from.

The short answer: yes — with the maneuver first, and the bar never meeting an active spin

Decompose the question into three checkable parts. One: does training itself endanger the condition? The danger is positional and mechanical, not structural — BPPV attacks last under a minute and are invariably provoked by typical changes in head position [1], so the hazard is where head position, load and height intersect: a bar on the spine, a bench, a pull-up bar, a ladder. That fall column is the real ledger: 12-fold fall odds for symptomatic vestibular dysfunction [2], and in Ménière's disease, more than one fall in the past year at OR 2.1 (1.8–2.5) [10]. Two: does the treatment change the program? Barely — and this is the door's gift: the treatment is a canalith repositioning procedure, strong-recommended by the guideline that stands on 2 clinical practice guidelines, 20 systematic reviews and 27 randomized trials, with a strong recommendation against postprocedural postural restrictions [3]; the original series resolved 100% of 30 patients [4]; pooled success runs 71.5% after one session, 91.4% cumulatively, with disability improving at SMD 1.56 [6]. Three: does training help the condition? Here the Cochrane draws the line this whole file programs from: vestibular rehabilitation is safe and effective for unilateral peripheral vestibular dysfunction across 27 trials and 1,668 participants — but for BPPV specifically, repositioning maneuvers beat exercise-based rehabilitation on short-term cure rate, and the combination serves longer-term functional recovery [5]. The short answer stands on all three — and then meets its three honest moderators: the differential (positional spins are BPPV-shaped, but vestibular migraine — the most common cause of recurrent spontaneous vertigo at ~1% lifetime prevalence [9] — Ménière's [10] and persistent postural-perceptual dizziness [11] program differently), the recurrence column (16% pooled [6], up to a quarter of elderly patients within a year [7]), and the chronic tail that outlives the crystals [11]. The rest of this file prices all three.

The mechanics: loose crystals, a position trigger, and a balance system you cannot bluff

Why does the room spin when you lie down? Because in BPPV, free-moving densities sit in the endolymph of a semicircular canal where they do not belong — the mechanism Epley's original paper itself argued from, noting the densities are free in the canal rather than attached to the cupula [4] — so gravity turns head position into a false rotation signal: attacks under a minute, classically on lying down, rolling over, looking up or bending [1]. The diagnostic maneuver is the gym-map in miniature: the Dix-Hallpike brings the patient supine with the head turned 45° to one side and the neck extended 20°, affected ear down [3] — the exact geometry of a decline bench setup, a hard sit-up, a head-hanging stretch or the bottom of some ab work. Three operational facts fall out for the lifter. The trigger fence: your attacks are position-shaped, which means the gym's trigger map is re-riggable — the movements that approximate the diagnostic position are the ones to pad, slow or swap while the condition is active [1][3]. The fall fence: the balance system in question is the one that keeps you upright under a bar; vestibular dysfunction affects 35.4% of adults 40+, and the symptomatic carry 12× the fall odds [2] — in a barbell gym, a fall is not a stumble but a loaded event. The treatment fence: the maneuver relocates the particles [4], the guideline says treat or refer for it [3], and vestibular suppressants — the dimming pills — are explicitly what the guideline wants used less, because they dull exactly the readout the maneuver and the diagnosis work with [3]. None of this is a case against lifting. It is the case for sequencing the maneuver before the barbell, and for programming positions, meds and load with the same seriousness as the squat.

The reframe: the treatment is itself a movement protocol

Every other file in this library treats exercise as the intervention that manages a condition. In this one, medicine got there first: the definitive treatment for the most common vertigo is a timed series of head movements — the canalith repositioning procedure, designed for "induced out-migration of free-moving pathological densities in the endolymph" using "timed head maneuvers" [4]. The lifter should recognize what that is: a movement protocol with positions, sequencing and a dose, which is why this population is unusually well-suited to it. The evidence ledger: 100% timely resolution of the classic nystagmus and positional vertigo in the original 30 patients [4]; a clinical practice guideline built on 2 CPGs, 20 systematic reviews and 27 RCTs issuing the strong recommendation to treat posterior canal BPPV with a repositioning procedure [3]; and 2026 pooling across 12 studies and 1,385 patients at 71.5% success after one session, 91.4% cumulative, disability improving at SMD 1.56 [6]. And then the field's most liberating sentence for a gym population: a strong recommendation against postprocedural postural restrictions [3] — the old "sleep upright for two days" era is over; you do not need to camp in a recliner after the maneuver. What changes is not whether you train, but the order of operations: the maneuver is the treatment, the re-rigged gym is the environment, and the program you were running is the destination.

The maneuver file, honestly: what the treatment table actually delivers

The maneuver deserves full resolution before anyone oversells it. Epley's 1992 series: 30 patients with classic Hallpike nystagmus, timely resolution of nystagmus and positional vertigo in 100% — but 10% continued atypical symptoms suggesting concomitant pathology, and 30% recurred, all responding to retreatment [4]. The 2026 meta-analysis of repositioning (delivered via mechanical chair, the complex-case instrument): 71.5% after one session, 91.4% cumulatively across sessions, residual dizziness in 16.1%, recurrence at 16%, disability improving at SMD 1.56 [6]. The population scandal that motivates this door: in the survey that measured it, only 8% of affected individuals had ever received effective treatment [1] — the modal vertigo patient is an untreated one, and the modal gym response ("wait it out") extends the modal medical failure. The guideline's honest edges: maneuvers are clinician-delivered or clinician-taught — the strong recommendation is to treat or refer [3]; suppressants and routine imaging are the two things it explicitly wants less of [3]; and refractory or multi-canal cases are where the specialized chairs and the follow-up visits live [6]. What the file refuses to do is turn the maneuver into a DIY party trick learned from a video — self-treatment without diagnosis is how a vestibular-migraine patient wastes months repositioning crystals she does not have [9].

The rehab file: what vestibular rehabilitation can and cannot do

Vestibular rehabilitation is the exercise column, and the Cochrane prices it precisely. Across 27 trials and 1,668 participants, VR is a safe and effective management for unilateral peripheral vestibular dysfunction, with no reported adverse effects — individual and pooled data showing significant benefit over control or no intervention, and medium-term resolution of symptoms and improved functioning [5]. Then the line that structures every program in this file: for the specific diagnostic group of BPPV, physical repositioning maneuvers are more effective than exercise-based vestibular rehabilitation in the short term — although a combination of the two is effective for longer-term functional recovery [5]. The Brazilian trials price the combination at street level. In São Paulo, 82 older adults with chronic dizziness from vestibular disorders ran conventional versus multimodal Cawthorne & Cooksey protocols — both improved balance control, results persisting at three months, the multimodal protocol winning on specific static balance tests (sensory Romberg eyes closed +4.27 s; unipedal left eyes open +4.08 s) [12]. In Natal, elderly chronic BPPV patients randomized to balance rehabilitation added to canalith repositioning — dynamic balance improved beyond the maneuver alone (p<0.05 across most tests), while dizziness symptoms and quality-of-life gains came from the maneuver itself [13]. Read as a lifter: the maneuver ends the spins, the rehabilitation rebuilds the balance chassis underneath the barbell — and claiming the rehab replaces the maneuver is exactly backwards [5][13].

The differential: not every spin is crystals

This is the section that keeps a training file from becoming a pamphlet, because "vertigo" is a symptom, not a diagnosis, and the program changes with the cause. Positional spins under a minute, provoked by lying down, rolling or looking up — that is BPPV's signature, confirmed by Dix-Hallpike, treated by the maneuver [1][3][4]. Recurrent spontaneous attacks lasting minutes to hours, in a person with migraine or its family — that is vestibular migraine, the most common cause of recurrent spontaneous vertigo at roughly 1% lifetime prevalence, riding the facts that migraine affects ~14% of the population and dizziness/vertigo 20–30%, with BPPV and Ménière's themselves carrying excess migraine comorbidity [9]; the migraines door owns that programming, including its exercise column. Spinning attacks of hours with ear pressure, hearing fluctuation, tinnitus and hearing loss — that is Ménière's territory, where the UK Biobank file prices the training-relevant burden: more than one fall in the past year at OR 2.1 (1.8–2.5), tinnitus at OR 68.3, higher odds with age, female sex and higher BMI [10]. Persistent non-spinning dizziness and unsteadiness lasting three months or more, worse upright, worse in complex visual environments — persisting after the periphery has healed — that is persistent postural-perceptual dizziness, the Bárány Society consensus diagnosis [11], and it is graded-exposure work, not rest. And the honest drug column for the migraine door: the field's own phase III RCT of metoprolol for vestibular migraine prophylaxis found no benefit over placebo (incidence rate ratio 0.983, 95% CI 0.902–1.071) with both arms improving by a factor of 0.830 per month — terminated at 130 of 266 planned patients for accrual, an honest null, not a verdict [14]. The red-flag fence rides above all of them: a first, sudden or worst-ever spin with double vision, slurred speech, weakness, incoordination or new hearing loss is an emergency-department event, not a gym-mobility question [3].

The recurrence column: the comeback file

The maneuver ends the episode; it does not end the condition. The recurrence ledger: 16% pooled in the 2026 meta-analysis [6]; 30% in Epley's original series, every recurrence responding to retreatment [4]; and in 286 elderly patients followed for a year after repositioning, 73 — 25.5% — recurred [7]. What makes this column lifter-relevant is that its predictors are testable, not folklore: the recurrence group ran lower 25-hydroxyvitamin D (15.34 vs 18.44 ng/mL) and lower serum calcium (1.94 vs 2.35 mmol/L), both independently predictive (adjusted OR 0.808 per vitamin D unit, OR 0.301 for calcium), alongside hypertension OR 2.237, sleep disorders OR 2.113, cervical spondylosis OR 2.167 and anxiety OR 2.726 — a combined model at AUC 0.762 [7]. That is a labs-and-lifestyle fence: vitamin D and calcium are blood draws, sleep is a trainable behavior with its own exercise column, anxiety is manageable, and none of it requires shelving the barbell. The trauma fence sits beside it: across 7 cohorts and 4,074 patients, traumatic BPPV ran recurrence at RR 3.39 (3.07–3.74), repositioning difficulty at RR 3.05, lower treatment efficacy at RR 0.87, multi-canal involvement at RR 2.91 and bilateral disease at RR 3.37 versus idiopathic [8] — the head-injury lifter (the concussion door's population) carries the comeback at triple odds and should know it before the first post-injury spin gets dismissed as "just dizziness."

The honest counterfile: what this file cannot promise

Five honesties keep this file from becoming a gym leaflet. No exercise trial prevents BPPV onset: nothing in this file prevents a first attack — the evidence begins after diagnosis, and "training to avoid vertigo" is not a claim anyone has tested. The maneuver numbers are clinician-delivered success: 100% [4], 71.5% [6] and the guideline's strong recommendation [3] describe diagnosed, treated patients — not self-diagnosed video-followers; the guideline's own structure is treat-or-refer [3]. The rehabilitation gains are balance and function, not vertigo cure: in the Natal trial, dizziness and quality-of-life improvement came from the maneuver, not the added balance work [13]; in the Cochrane, the maneuver beats exercise-VR short-term for BPPV [5]; and both Brazilian trials are older adults — 82 and 14 per arm, small and elderly, generalizable with care [12][13]. The metoprolol null is one underpowered, terminated trial: PROVEMIG randomized 130 of 266 planned patients — an honest absence of evidence, not evidence that drugs never work for vestibular migraine [14]. And the risk columns are observational: the 12× fall odds are cross-sectional association, not causation [2]; the vitamin D and calcium predictors are a single-center elderly cohort awaiting external validation, whose own authors call the model an adjunct, not a standalone test [7]; and the trauma meta-analysis pools cohorts that cannot fully adjust confounding [8]. What survives the counterfile is still sufficient to program: the maneuver works and is underdelivered [1][3][4][6], the sequencing is Cochrane-priced [5], the fall fence is real [2][10], and the recurrence levers are testable [7][8].

The session rules: programming that survives a spinning room

This is the section that separates this door from a neurology pamphlet. Each rule is priced against the ledgers above:

  1. No active spin under a loaded bar. Symptomatic vestibular dysfunction carries 12× the fall odds [2], and a BPPV attack is short but not schedulable [1] — if the room is spinning today, today is not squat day; rerack, reschedule, treat.
  2. Treat before you train through. The maneuver comes first: strong-recommended [3], 71.5% after one session [6], 100% in the original series [4] — training through an untreated episode is programming around a condition medicine ends in minutes.
  3. Skip the postural restrictions — the guideline does. The strong recommendation is against postprocedural restrictions after repositioning [3] — 24–48 hours of positional common sense is comfort, not prescription; the recliner-camping era is over.
  4. Re-rig the trigger positions. The Dix-Hallpike shape — supine, head turned 45°, neck extended 20° [3] — appears in decline benches, hard sit-ups and head-hanging setups [1]; pad, slow or swap them while the condition is active, mechanism-reasoned and labeled as such.
  5. Don't mask with suppressants to keep training. The guideline explicitly targets reduced use of vestibular suppressants [3] — they dim the readout the diagnosis and the maneuver work with, and they turn a treatable trigger into a chemically-fogged one.
  6. Program the rehabilitation as training. Gaze-stability and balance work is a doseable capacity — safe and effective across 27 trials [5], additive for dynamic balance beyond the maneuver [13], maintained at follow-up [12] — progressed like any other column, not done vaguely.
  7. Pull the recurrence levers that are testable. Vitamin D and calcium are labs [7]; sleep is a behavior [7]; anxiety is addressable [7]; after head trauma, expect the comeback at RR 3.39 and plan follow-up accordingly [8].
  8. Log episodes, maneuvers and sessions on one timeline. "Did the maneuver hold?" is only answerable with dates — the training log is the clinic-visit artifact here more than in any door in this library [1][7].

The fences, in order

  1. The diagnosis fence. Positional spins under a minute get a Dix-Hallpike and the maneuver [1][3]; spontaneous recurrent attacks get the migraines file [9]; hours-long spins with ear symptoms get the Ménière's workup [10]; persistent non-spinning dizziness gets the PPPD evaluation [11] — self-repositioning without diagnosis wastes the differential's time.
  2. The red-flag fence. First, sudden or worst-ever spin with double vision, slurred speech, weakness, incoordination or new hearing loss is an emergency, not a mobility question [3].
  3. The fall fence. No bar on the spine, no ladder work, no overhead near failure while spinning — 12× fall odds [2] and Ménière's 2.1 fallen-more-than-once [10] make the loaded fall the one unaffordable event.
  4. The trauma fence. Post-head-injury BPPV recurs at RR 3.39 with harder repositioning [8] — the concussion door owns return-to-play; this door owns the expectation-setting.
  5. The chronic-tail fence. Dizziness persisting three months past clean maneuvers is a PPPD conversation — graded exposure and progression [11], not rest and avoidance; the sick-day fence logic applies to episodes, not to diagnoses.

The Brazilian anchors

The pt-BR reader sits on native file here — two of them, plus a school. The São Paulo anchor: the UNIFESP otoneurology group randomized 82 older adults with chronic dizziness from vestibular disorders to conventional versus multimodal Cawthorne & Cooksey protocols — both improved balance control with results persisting at three months, the multimodal winning on sensory-Romberg and unipedal-stance tests [12]. The Natal anchor: the UFRN trial adding 50-minute twice-weekly balance rehabilitation to canalith repositioning in elderly chronic BPPV — dynamic balance improving beyond the maneuver alone (p<0.05), with the honest finding that dizziness and quality-of-life gains came from the maneuver itself [13]. Both trials belong to the Brazilian vestibular-rehabilitation tradition that runs through the country's otoneurology services — and both were run in older adults, which is stated plainly: the balance-chassis evidence is strongest exactly where the fall ledger is scariest [2][12][13]. For the Brazilian marombeiro, nothing here is imported: the rehabilitation protocols were tested in São Paulo and Rio Grande do Norte, in Portuguese, on the population that trains.

So what do you do in practice? The practical file

Seven rules, all sourced from the files above:

  1. Get the diagnosis before the self-treatment — positional <1-minute spins are BPPV-shaped [1][3]; the differential (migrainous, Ménière's, PPPD) changes the program completely [9][10][11].
  2. Take the maneuver seriously as the treatment — treat or refer, strong recommendation [3]; one session resolves 71.5% and the cumulative ledger runs to 91.4% [6].
  3. Return to training after the maneuver, not after the fear — no postural restrictions is the guideline's position [3]; the program you were running is the destination.
  4. Re-rig the trigger positions — decline work, hard sit-ups and head-hangs approximate the diagnostic geometry [1][3]; pad, slow or swap while active.
  5. Add the balance work as a real column — safe, effective, additive for dynamic balance [5][12][13]; progress it like progressive overload progresses anything else.
  6. Pull the labs and mind the lifestyle — vitamin D, calcium, sleep and anxiety are the recurrence levers with numbers behind them [7]; trauma triples the comeback [8].
  7. Track episodes, maneuvers and sessions on one dated timeline — the recurrence question is only answerable with data [1][7], and the dose engine you return to deserves a clean re-entry.

How RightRep fits into this

The vertigo ledger runs on one currency this app counts better than any notebook — the dated, dosed, typed session record:

  • The episode timeline needs one calendar. "Did the maneuver hold? Was that a bad week or a recurrence week?" is only answerable when episodes, maneuvers and session quality share dates [1][7] — the log is where that correlation becomes visible before the follow-up visit.
  • The re-entry needs honest dosing. Effort-typed sessions keep the post-maneuver return honest about which week actually reloaded the program and which week only felt like it [3][6].
  • The balance column needs a progression record. The rehabilitation that adds dynamic balance beyond the maneuver [13] is a trainable capacity — tracked, progressed, and visible.
  • The fall fence needs early flags. Spinning-episode annotations beside load trends are exactly the pattern a vestibular clinician wants described [2][3] — recorded at the session, not recalled from memory.
  • The clinic-visit artifact. "How have you actually been training, sleeping and trending since the maneuver?" — answered by the dated record you hand over, not by recollection [1][3].

The final tally

  • The scale file: BPPV lifetime prevalence 2.4%, one-year 1.6%, incidence 0.6%, median episode two weeks — and only 8% of affected people ever effectively treated [1]; vestibular dysfunction in 35.4% of US adults 40+ (69 million) [2].
  • The maneuver ledger: 100% resolution in the original 30 [4]; strong recommendation with postural restrictions strongly advised against [3]; 71.5% after one session, 91.4% cumulative, residual dizziness 16.1%, disability SMD 1.56 [6].
  • The sequencing ledger: Cochrane, 27 trials/1,668 — VR safe and effective for unilateral peripheral vestibular dysfunction, but repositioning beats exercise-VR short-term for BPPV; the combination owns long-term functional recovery [5].
  • The differential ledger: vestibular migraine ~1% lifetime, the most common recurrent spontaneous vertigo [9]; Ménière's with falls OR 2.1 and tinnitus OR 68.3 [10]; PPPD as the three-month chronic tail [11]; metoprolol null at IRR 0.983 [14].
  • The recurrence ledger: 16% pooled [6], 30% in the original series [4], 25.5% at one year in the elderly with vitamin D (OR 0.808), calcium (OR 0.301), sleep (OR 2.113) and anxiety (OR 2.726) as predictors [7]; trauma at RR 3.39 [8].
  • The Brazil ledger: São Paulo's 82-elder balance trial, gains maintained at three months [12]; Natal's maneuver-plus-balance trial, dynamic balance beyond the maneuver alone [13].
  • The fences: diagnosis before self-treatment, red flags before everything, no load during active spins, labs before folklore, graded exposure for the chronic tail.

Train like the maneuver is the treatment, the trigger is a position you can re-rig, and the barbell is the return destination — episodes logged, labs pulled, fences standing: at rightrep.app.

This post was written by the RightRep AI Assistant — the same AI that counts and scores your repetitions at rightrep.app.

Sources

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  2. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med, 2009;169(10):938–944. pubmed.ncbi.nlm.nih.gov
  3. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Steiner RW, Do BT, Voelker CC, Waguespack RW, Corrigan MD. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head Neck Surg, 2017;156(3 Suppl):S1–S47. pubmed.ncbi.nlm.nih.gov
  4. Epley JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg, 1992;107(3):399–404. pubmed.ncbi.nlm.nih.gov
  5. Hillier SL, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev, 2011;(2):CD005397. pubmed.ncbi.nlm.nih.gov
  6. Sévenne É, Makhoul M, Nieto P, Molinier CE, Deguine O, Marx M, Legois Q. Contribution of the repositioning chair in the treatment of patients with benign paroxysmal positional vertigo: a systematic review and meta-analysis. Acta Otolaryngol, 2026;146(7):783–799. pubmed.ncbi.nlm.nih.gov
  7. Zhang X, Pu X, Wang Y, Li X, Pan Q. A predictive model of serum calcium and 25-hydroxyvitamin D for recurrence of benign paroxysmal positional vertigo in the elderly: a single-center follow-up cohort study. Front Neurol, 2026;17:1865876. pubmed.ncbi.nlm.nih.gov
  8. Fu Y, Zhao Z. Meta-analysis of the therapeutic effects of traumatic BPPV and idiopathic BPPV. Front Neurol, 2026;17:1834081. pubmed.ncbi.nlm.nih.gov
  9. von Brevern M, Neuhauser H. Epidemiological evidence for a link between vertigo and migraine. J Vestib Res, 2011;21(6):299–304. pubmed.ncbi.nlm.nih.gov
  10. Tyrrell JS, Whinney DJ, Ukoumunne OC, Fleming LE, Osborne NJ. Prevalence, associated factors, and comorbid conditions for Ménière's disease. Ear Hear, 2014;35(4):e162–e169. pubmed.ncbi.nlm.nih.gov
  11. Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, Bronstein A. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the Committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res, 2017;27(4):191–208. pubmed.ncbi.nlm.nih.gov
  12. Ricci NA, Aratani MC, Caovilla HH, Ganança FF. Effects of Vestibular Rehabilitation on Balance Control in Older People with Chronic Dizziness: A Randomized Clinical Trial. Am J Phys Med Rehabil, 2016;95(4):256–269. pubmed.ncbi.nlm.nih.gov
  13. Ribeiro KM, Freitas RV, Ferreira LM, Deshpande N, Guerra RO. Effects of balance Vestibular Rehabilitation Therapy in elderly with Benign Paroxysmal Positional Vertigo: a randomized controlled trial. Disabil Rehabil, 2017;39(12):1198–1206. pubmed.ncbi.nlm.nih.gov
  14. Bayer O, Adrion C, Al Tawil A, Mansmann U, Strupp M; PROVEMIG investigators. Results and lessons learnt from a randomized controlled trial: prophylactic treatment of vestibular migraine with metoprolol (PROVEMIG). Trials, 2019;20(1):813. pubmed.ncbi.nlm.nih.gov