![]() ![]() We included 11 trials in the review with a total of 745 patients.įive studies compared the efficacy of the Epley manoeuvre against a sham manoeuvre, three against other particle repositioning manoeuvres (Semont, Brandt-Daroff and Gans) and three against a control (no treatment, medication only, postural restriction). This evidence is up to date to January 2014. Seven of the trials blinded the assessors to the patients' treatment group and data on all outcomes for all participants were reported in most studies. All trials were randomised, with five studies applying sealed envelope or external allocation techniques. There was a low risk of overall bias in the studies included. Other specific sequences of physical movements, the Semont and Gans manoeuvres, have similar results. The review of trials found that the Epley manoeuvre is safe and effective in the short term. Some patients were unable to tolerate the manoeuvres because of cervical spine (neck) problems. Rates of nausea during the repositioning manoeuvre varied from 16.7% to 32%. ![]() There were no serious adverse effects of treatment. In one study a single Epley treatment was more effective than a week of three times daily Brandt-Daroff exercises.Īdverse effects were not often reported. There was no difference when Epley was compared with the Semont or Gans manoeuvre. When studies looked at the conversion from a positive to a negative Dix-Hallpike test (a test to diagnose BPPV) in the patients, the results significantly favoured the Epley treatment group when compared to a sham manoeuvre or control. None of the trials that compared Epley versus other particle repositioning manoeuvres reported vertigo resolution as an outcome. All patients were adults aged 18 to 90 years old, with a sex ratio of 1:1.5 male to female.įor resolution of vertigo the Epley manoeuvre was significantly more effective than a sham manoeuvre or control. Patients were treated in hospital otolaryngology (ear, nose and throat) departments in eight studies and family practices in two studies. Five studies (334 patients) compared the efficacy of the Epley manoeuvre against a sham manoeuvre, three against other particle repositioning manoeuvres (Semont, Brandt-Daroff and Gans) and three with a control (no treatment, medication only, postural restriction). ![]() We included 11 studies in the review, with a total of 745 participants. This linked video demonstrates how the Epley manoeuvre is performed. It is understood to work by moving the canal debris out of the semicircular canal. audiological scientist, physiotherapist) and involves a series of four movements of the head and body from sitting to lying, rolling over and back to sitting. The Epley manoeuvre is a treatment that is performed by a doctor (or other health personnel with appropriate training, e.g. This causes a sensation of ongoing movement that conflicts with other sensory information. BPPV can be caused by debris in the semicircular canal of the ear, which continues to move after the head has stopped moving. Common causes are head trauma or ear infection. The person feels they or their surroundings are moving or rotating. Benign paroxysmal positional vertigo (BPPV) is caused by a rapid change in head movement. ![]()
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