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Treatments for Benign Paroxysmal Positional Vertigo (BPPV)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00000359
Recruitment Status : Completed
First Posted : November 3, 1999
Last Update Posted : July 26, 2012
National Institute on Deafness and Other Communication Disorders (NIDCD)
Information provided by (Responsible Party):
Helen Cohen, Baylor College of Medicine

Brief Summary:
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.

Condition or disease Intervention/treatment Phase
Vertigo Behavioral: Canalith repositioning maneuver (Epley maneuver) Behavioral: Semont maneuver Behavioral: Brandt-Daroff exercises Behavioral: Vestibular habituation exercises Behavioral: ShamManeuver Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 150 participants
Allocation: Randomized
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Treatments for Benign Paroxysmal Positional Vertigo (BPPV)
Study Start Date : October 1998
Actual Primary Completion Date : June 2003
Actual Study Completion Date : June 2003

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Canalith repositioning maneuver
Repositioning treatment for posterior canal BPPV
Behavioral: Canalith repositioning maneuver (Epley maneuver)
Standard passive motion of the head: Dix-Hallpike maneuver, turn head to opposite side, roll over, sit up.
Other Names:
  • CRP
  • Epley maneuver

Experimental: Modified Epley maneuver Behavioral: Vestibular habituation exercises
Head shaking exercises in pitch, roll, yaw and circumduction. Titrating from 2 repetitions per exercise to 20 repetitions per exercise, as tolerated.

Sham Comparator: Sham
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.
Behavioral: ShamManeuver
Passive movement of the head

Active Comparator: Liberatory maneuver
The standard liberatory maneuver (also known as the Semont maneuver) was used.
Behavioral: Semont maneuver
Sidelying maneuver, flip over 180 deg, sit up.
Other Name: Liberatory maneuver

Active Comparator: Brandt Daroff exercise
Modified Brandt Daroff exercise performed as a self-liberatory exercise.
Behavioral: Brandt-Daroff exercises
Active exercise. Sidelying to involved side, sidelying to uninvolved side, sit up.

Primary Outcome Measures :
  1. Vertigo [ Time Frame: 6 month s ]

Secondary Outcome Measures :
  1. Balance [ Time Frame: 6 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   21 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00000359

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United States, Texas
Baylor College of Medicine
Houston, Texas, United States, 77030
Sponsors and Collaborators
Baylor College of Medicine
National Institute on Deafness and Other Communication Disorders (NIDCD)
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Principal Investigator: Helen Cohen, EdD Baylor College of Medicine
Publications of Results:
Other Publications:
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Responsible Party: Helen Cohen, Professor, Baylor College of Medicine Identifier: NCT00000359    
Other Study ID Numbers: NIDCD-1156
R01DC003602 ( U.S. NIH Grant/Contract )
1R01DC003602-01A1 ( U.S. NIH Grant/Contract )
First Posted: November 3, 1999    Key Record Dates
Last Update Posted: July 26, 2012
Last Verified: July 2012
Keywords provided by Helen Cohen, Baylor College of Medicine:
Physical Therapy
occupational therapy
Additional relevant MeSH terms:
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Benign Paroxysmal Positional Vertigo
Vestibular Diseases
Labyrinth Diseases
Ear Diseases
Otorhinolaryngologic Diseases
Neurologic Manifestations
Nervous System Diseases
Sensation Disorders