Testing the Epley Maneuver for Treating Dizziness in the Emergency Department: A Randomized Study

American University of Beirut Medical Center

Status: Not yet enrolling

Conditions: Benign Paroxysmal Positional Vertigo (BPPV)

Treatments: Procedure: Epley Maneuver; Procedure: Sham maneuver

Study type: Interventional

Funder types: Other

Identifiers

NCT07111000

BIO-2023-0184

Details and patient eligibility

About

The goal of this randomized controlled trial is to evaluate the efficacy of the Epley maneuver versus a sham maneuver in treating patients presenting to the emergency department (ED) with BPPV. The main questions that the study aims to answer are:

• What is the mean difference in Dizziness Handicap Inventory (DHI) scores between patients receiving the Epley maneuver and those receiving the sham maneuver 3 days after enrollment?
• What is the immediate response (using a 0-10-point Likert scale) of patients in each arm of the study?
• What is the proportion of patients who, despite agreeing to participate, were unable to complete the full Epley maneuver due to symptom severity?

Researchers will compare the Epley maneuver arm to the sham maneuver arm to see if the Epley maneuver is more effective in reducing BPPV symptoms.

Participants will:

• Undergo either the Epley maneuver or a sham maneuver.
• Complete the Dizziness Handicap Inventory (DHI) questionnaire at baseline and 3 days post-discharge.
• Patients with insufficient improvement in the sham maneuver group will receive a rescue Epley maneuver.
• Have their vertigo severity assessed using a 0-10 point Likert scale at baseline, immediately and post-maneuver.

Enrollment: 118 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Patients presenting to the ED with symptoms of BPPV (single or recurrent episodes of vertigo lasting up to 2 minutes) and a positive DHT (episode of vertigo associated with torsional upbeating nystagmus) indicating a posterior semicircular canal BPPV.

Patients who are able to understand and provide a signed informed consent to participate in the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Double Blind

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118 participants in 2 patient groups

Epley Maneuver

Experimental group

Description:

The patient's head is turned 45 degrees towards the side that caused the most nystagmus or reproduced their initial symptoms. The patient is then laid down with their head hanging over the edge of the bed. After that, the head will be rotated 90 degrees in the opposite direction, with the head remaining in a dependent position. The patient is then asked to roll onto their side with their head facing downward. They are then brought back to a sitting position and the head is moved forward 45 degrees. Each position is held until the vertigo and/or nystagmus subsides or for at least 30 seconds

Treatment:

Procedure: Epley Maneuver

Sham Maneuver

Sham Comparator group

Treatment:

Procedure: Sham maneuver