OBJECTIVE: To determine the efficacy of a home-based exercise program by comparing it with betahistine in patients with benign paroxysmal positional vertigo (BPPV). STUDY DESIGN: Prospective, randomized, controlled study. SETTING: Outpatient clinic of a university hospital. PATIENTS: Thirty-eight patients (10 males, 28 females; mean age 46 +/- 13 years) diagnosed as having BPPV. INTERVENTIONS: Patients were randomly assigned to either an exercise or a medication group. In the medication group, betahistine was prescribed at 24 mg/d for 1 month. The exercise group was required to perform Cawthorne-Cooksey exercises six times/day for 4 weeks. MAIN OUTCOME MEASURES: The Vertigo, Dizziness, Imbalance Questionnaire (VDI), which consists of two subscales, the VDI symptom subscale (VDI-ss) and the VDI health-related quality of life (VDI-HRQoL) subscale, and the Vertigo Symptom Scale (VSS) were used for assessment at the beginning of the study and after 2 months. RESULTS: The mean scores of the two components of the VDI and the VSS decreased in the exercise group by the fourth week. In the medication group, VSI mean scores, VDIss mean scores, and VSS mean scores decreased in the second week and VDI-HRQoL mean scores decreased in the fourth week. However, there were no significant differences between baseline and week 8. There were significant differences between groups regarding the change in the mean scores of the VDI (p = 0.001) and the VSS (p = 0.001) at the end of the study in favour of the exercise group. CONCLUSIONS: Exercise was found to be a better treatment choice than medication and may be preferable for patients with persistent or chronic vertigo.

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