A comparative study on effectiveness of the rolling-over maneuver in rehabilitation of patients with posterior semicircular canal benign paroxysmal positional vertigo

Abstract

Abstract Hypothesis: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder. The canalith repositioning procedure (CRP) is known to be an effective therapy for the treatment of BPPV. However, because of its various movements of the head and body, it is impossible to perform in BPPV patients with orthopedic impairments or in the elderly. The rolling-over maneuver (ROM) involves easy movements, with only a small load. This therapy is suitable for most BPPV patients, especially for those without an indication for CRP. Hence, we propose that ROM is as effective as CRP for the treatment of BPPV. Purpose: In this study, we compared among the ROM, Epley, and Brandt-Daroff maneuvers in the management of patients with posterior semicircular canal-type BPPV. Patients and methods: The study included 60 patients with BPPV who were randomized and divided into the following three groups: (i) those treated by Epley maneuver as CRP; (ii) those treated by ROM; and (iii) those treated by the Brandt-Daroff maneuver. Results: The findings of this study demonstrated that the success rate was the best in patients who were treated with Epley maneuver (90%), then in patients treated with ROM (85%) followed by those treated with the Brandt-Daroff maneuver (80%). The recurrence rate after management was high in patients treated with the Brandt-Daroff maneuver (31.25%), with no statistically significant difference. Conclusion: We recommend either Epley maneuver in the office or ROM at home, according to the general condition of the patient.