Gait and Falls in Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis.

Only one study assessed fall incidence prospectively; the rest relied on retrospective self-reports, which are subject to recall bias. No study compared PRM to a placebo or to other treatments, so the specific contribution of PRM cannot be isolated. Eight of the 15 treatment studies had a single-group pre/post design with no control group. The reporting period for falls ranged from 90 days to 2 years across studies, making it hard to compare. Gait studies included broad age ranges while fall studies focused mainly on older adults, so the findings may not generalise across ages. Individual meta-analyses were small, pooling only 3 to 7 studies each.

The authors declare no conflict of interest. No funding source is named.

Do not read the positive results as evidence that PRM fully restores gait. Tandem walking did not improve after PRM, and walking with head movements showed no improvement at 1 month, only at 6 and 12 months. Most fall data came from retrospective self-reports rather than prospective tracking, so the true reduction in falls may be smaller than reported.