Treatments for Benign Paroxysmal Positional Vertigo (BPPV)

Baylor College of Medicine

Status and phase

Completed

Phase 2

Conditions

Vertigo

Treatments

Behavioral: Brandt-Daroff exercises

Behavioral: Canalith repositioning maneuver (Epley maneuver)

Behavioral: Semont maneuver

Behavioral: ShamManeuver

Behavioral: Vestibular habituation exercises

Study type

Interventional

Funder types

Other

NIH

Identifiers

NCT00000359

R01DC003602 (U.S. NIH Grant/Contract)

1R01DC003602-01A1 (U.S. NIH Grant/Contract)

NIDCD-1156

Details and patient eligibility

About

The purpose of this study was to determine the relative short- and long-term efficacy of several physical treatment paradigms commonly employed for the treatment of benign paroxysmal positional vertigo (BPPV), including the canalith repositioning (Epley) maneuver, the liberatory (Semont) maneuver, the Brandt-Daroff exercises and nonspecific vestibular habituation exercises. These procedures involve exercises and head manipulations. Vertigo intensity and frequency, the presence/absence of slow-phase eye movements, the degree of dizziness handicap and acts of daily living (ADL) were assessed. The study also ascertained the effects of co-morbid conditions on the response to treatment. While BPPV is a common and significant public health problem that has been recognized for several decades, this is the first systematic study of the relative treatment efficacy of different physical treatment modalities for this disorder.

Enrollment

150 patients

Sex

All

Ages

21+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients may be eligible for this study if they:

Are at least 21 years old.
Have a diagnosis of unilateral posterior semicircular canal BPPV according to established clinical test criteria.
Have functional to normal range of motion of the neck and the back.

Exclusion criteria

Patients will not be eligible for this study if they:

Have a history of prior ear surgery or prior treatment for BPPV.
Have an orthopedic or connective tissue disorder that impairs functional neck or trunk range of motion.
Have a significant neurological disorder or spinal cord damage.
Are on vestibular suppressant medications.
Have Meniere's disease or acoustic neuromas.

Trial design

150 participants in 5 patient groups

Canalith repositioning maneuver

Experimental group

Description:

Repositioning treatment for posterior canal BPPV

Treatment:

Behavioral: Canalith repositioning maneuver (Epley maneuver)

Modified Epley maneuver

Experimental group

Treatment:

Behavioral: Vestibular habituation exercises

Sham

Sham Comparator group

Description:

The subject sat in a chair; the head was passively tilted downward, turned away from the involved side, turned back to center, upward, away from the involved side, twice, slowly.

Treatment:

Behavioral: ShamManeuver

Liberatory maneuver

Active Comparator group

Description:

The standard liberatory maneuver (also known as the Semont maneuver) was used.

Treatment:

Behavioral: Semont maneuver

Brandt Daroff exercise

Active Comparator group

Description:

Modified Brandt Daroff exercise performed as a self-liberatory exercise.