Effect of different maneuvers of repositioning on benign paroxysmal vertigo: a network meta-analysis

Abstract

Background: The effect of different maneuver repositioning on benign paroxysmal vertigo was explored by network meta-analysis. Methods: The PubMed, Embase, Cochrane library, and web of science databases were searched for randomized controlled studies on the effect of manipulative repositioning on benign paroxysmal vertigo from database creation to September 1, 2024, Bayesian network meta-analysis, R4.4.1 was used for data analysis. Results: Twenty-two articles (n = 2507) were included in this study, and the results of network meta-analysis suggested the following odds ratios (OR) relative to the control group (UT): Epley maneuver (EM) vs UT [OR = 7.9, 95% CI (3.21, 23.31)]; Gufoni maneuver (GFM) vs UT [OR = 5.1, 95% CI (1.25, 21.45)]; Gans Repositioning Maneuvers (GRM) vs UT [OR = 11, 95% CI (1.65, 83.85)]; Modified Epley maneuver (MEM) vs UT [OR = 9.83, 95% CI (1.55, 64.06)]; Semont’s maneuver (SM) vs UT [OR = 6.1, 95% CI (1.97, 18.46)]. The largest surface area under the cumulative ranking curve was for GRM (71.5%), followed by MEM (68%) and SEM (67.8%), and the worst was for UT (5.7%). Conclusion: Based on our current findings, GRM, MEM and SEM are effective for BBPV symptoms, but due to the existence of study limitations, more high quality multicenter large sample randomized controlled studies are needed to testify to our conclusions.