Is a Mechanical Rotational Chair Superior to Manual Treatment Maneuvers on an Examination Bed in the Treatment of Benign Paroxysmal Positional Vertigo?

Objective: To compare the efficacy of the TRV-chair, a mechanical rotational chair, against manual treatment maneuvers in the treatment of benign paroxysmal positional vertigo (BPPV). Study design: Prospective open-label block-randomized controlled clinical trial. Setting: Tertiary referral center. Subjects: Seventy-four patients referred from primary care and subsequently diagnosed with BPPV. Intervention(s): Patients were randomized to diagnostics and treatment with either manual treatment maneuvers on an examination table or using the TRV-chair. Main outcomes: The primary outcome was treatment efficacy, defined as absence of positional nystagmus (with or without concomitant vertigo), following one treatment. Secondary outcomes were number of treatments necessary for treatment success and Dizziness Handicap Inventory (DHI) scores. Results: 61.1% of the subjects in the TRV-group and 63.2% in the manual treatment group were treated successfully (p ¼ 0.856). The differences in the number of treatments necessary to achieve treatment success as well as pre- and post-treatment DHI-scores between the TRV-group and the manual treatment group were nonsignificant. Conclusions: Traditional manual treatment maneuvers and treatment maneuvers performed with the TRV-chair are equally good at treating BPPV in patients referred directly from primary care.