TY - JOUR
T1 - Adding Kinetic Energy Does Not Further Improve Treatment Outcomes With a Mechanical Reposition Chair: A Randomized Controlled Trial
AU - Kjærsgaard, Jonas Bruun
AU - Petersen, Niels Krintel
AU - Hougaard, Dan Dupont
PY - 2023/1
Y1 - 2023/1
N2 - Objective To test if the addition of abrupt deaccelerations (kinetic energy) during treatment with a mechanical repositional chair (MRC) provides improved treatment efficacy with treatment of posterior benign paroxysmal positional vertigo (BPPV). Study Design Randomized two-armed parallel open-labeled clinical trial. Setting Tertiary referral center. Patients Seventy patients diagnosed with posterior canalolithiasis BPPV were included. Intervention(s) All patients underwent diagnostics and treatment with an MRC. Patients were randomized to either a traditional Epley maneuver or a potentiated version of the Epley maneuver where kinetic energy was applied in five positions with 45-degree turns between each step. Main Outcome Measure(s) Primary endpoint was the number of treatments needed before complete resolution of both subjective symptoms and objective signs of BPPV within the semicircular canal of interest. Secondary endpoints included the following: 1) number of patients requiring more than 10 treatments, 2) length of treatment in days before treatment(s) were successful, and 3) changes in total Dizziness Handicap Inventory scores before and after treatment. Results No significant difference in the number of required treatments between the two treatment arms was found. Approximately three of four subjects were cured after two repositional maneuvers regardless of type of treatment. An equal length of treatment was seen with both groups, and the Dizziness Handicap Inventory scores were significantly lowered after treatment with no significant differences between the two types of treatment. Conclusions Both the traditional and the potentiated Epley maneuver are efficient in treatment of canalolithiasis of the posterior semicircular canals with MRC. Addition of kinetic energy with this subgroup of BPPV patients does not seem to add further efficacy to the treatment.
AB - Objective To test if the addition of abrupt deaccelerations (kinetic energy) during treatment with a mechanical repositional chair (MRC) provides improved treatment efficacy with treatment of posterior benign paroxysmal positional vertigo (BPPV). Study Design Randomized two-armed parallel open-labeled clinical trial. Setting Tertiary referral center. Patients Seventy patients diagnosed with posterior canalolithiasis BPPV were included. Intervention(s) All patients underwent diagnostics and treatment with an MRC. Patients were randomized to either a traditional Epley maneuver or a potentiated version of the Epley maneuver where kinetic energy was applied in five positions with 45-degree turns between each step. Main Outcome Measure(s) Primary endpoint was the number of treatments needed before complete resolution of both subjective symptoms and objective signs of BPPV within the semicircular canal of interest. Secondary endpoints included the following: 1) number of patients requiring more than 10 treatments, 2) length of treatment in days before treatment(s) were successful, and 3) changes in total Dizziness Handicap Inventory scores before and after treatment. Results No significant difference in the number of required treatments between the two treatment arms was found. Approximately three of four subjects were cured after two repositional maneuvers regardless of type of treatment. An equal length of treatment was seen with both groups, and the Dizziness Handicap Inventory scores were significantly lowered after treatment with no significant differences between the two types of treatment. Conclusions Both the traditional and the potentiated Epley maneuver are efficient in treatment of canalolithiasis of the posterior semicircular canals with MRC. Addition of kinetic energy with this subgroup of BPPV patients does not seem to add further efficacy to the treatment.
KW - Benign paroxysmal positional vertigo
KW - BPPV
KW - Clinical epidemiology
KW - Mechanical rotary chair
KW - MRC
KW - Randomized controlled trial
KW - RCT
KW - TRV chair
UR - http://www.scopus.com/inward/record.url?scp=85143992319&partnerID=8YFLogxK
U2 - 10.1097/MAO.0000000000003757
DO - 10.1097/MAO.0000000000003757
M3 - Journal article
SN - 1531-7129
VL - 44
SP - e33-e41
JO - Otology & Neurotology
JF - Otology & Neurotology
IS - 1
ER -