Canalith repositioning variations for benign paroxysmal positional vertigo

Otolaryngol Head Neck Surg. 2010 Sep;143(3):405-12. doi: 10.1016/j.otohns.2010.05.022.


Objective: To determine if variations in common treatments for benign paroxysmal positional vertigo (BPPV) affected efficacy.

Study design: Prospective, pseudo-randomized study.

Setting: Outpatient practice in a tertiary care facility.

Subjects and methods: Patients (n = 118) with unilateral BPPV of the posterior canal, including 13 patients with BPPV of the lateral canal, were tested at a tertiary care center on one of five interventions: canalith repositioning maneuver (CRP), CRP plus home exercise, modified CRP, CRP for patients with involvement of two semicircular canals, and self-CRP home exercise. Self-CRP was also compared to previously published data on efficacy of the Brandt Daroff exercise. Main outcome measures were vertigo intensity and frequency, presence/absence of Dix-Hallpike responses, Vestibular Disorders Activities of Daily Living Scale (VADL), and computerized dynamic posturography.

Results: Vertigo intensity and frequency and Dix-Hallpike responses decreased significantly, and posturography and VADL improved significantly from pre- to post tests. No other significant changes were found. The groups did not differ significantly. Vertigo intensity and frequency were not strongly related at pretest but were related at post-test. Length of illness and age did not influence the results.

Conclusion: However the head is moved, as long as it is moved rapidly enough and through the correct planes in space, repositioning treatments are likely to be effective. Therefore, clinicians have a range of choices in selecting the treatment best suited for each patient's unique needs.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations / methods*
  • Patient Positioning*
  • Prospective Studies
  • Recovery of Function
  • Self Care*
  • Semicircular Canals*
  • Treatment Outcome
  • Vertigo / physiopathology
  • Vertigo / therapy*