Adding Kinetic Energy Does Not Further Improve Treatment Outcomes With a Mechanical Reposition Chair: A Randomized Controlled Trial

Jonas Bruun Kjærsgaard*, Niels Krintel Petersen, Dan Dupont Hougaard

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


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.
Original languageEnglish
JournalOtology & Neurotology
Issue number1
Pages (from-to)e33-e41
Number of pages9
Publication statusPublished - Jan 2023


  • Benign paroxysmal positional vertigo
  • BPPV
  • Clinical epidemiology
  • Mechanical rotary chair
  • MRC
  • Randomized controlled trial
  • RCT
  • TRV chair


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