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Published on: May 23, 2013
A randomized controlled trial comparing home-based modified Epley maneuver and Brandt-Daroff exercise for posterior
Nor Hanim Mohamad Hanapi1, Nurul Firdausi Hasnol Basri2,3, Adi Rizal Abdul Rahman3
1Department of Rehabilitation Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Background:
This study aimed to compare the effects of two home-based exercises, the self-Epley maneuver (SEM) and Brandt-Daroff exercise (BDE), in patients with posterior canal benign paroxysmal positional vertigo (BPPV).
Methods:
A total of 50 outpatients with unilateral posterior canal BPPV, a documented positive Dix-Hallpike test, and symptoms of vertigo for a duration of at least 1 week were randomized into the SEM and BDE groups. Patients in both groups performed home-based exercises for a total duration of 2 weeks. The primary outcome was vertigo resolution at 1 and 6 months. Secondary outcomes included conversion of a positive to a negative Dix-Hallpike test at 1 month and reduction in vertigo intensity and Dizziness Handicap Inventory (DHI) scores at 1 month and 6 months.
Results:
Vertigo resolution was achieved in 40% of the patients at 1 month and in 48% at 6 months in both groups. The conversion rates from positive to negative Dix-Hallpike test at 1 month were 92% and 84% in the SEM and BDE groups, respectively. There was a significant reduction in the vertigo intensity and an improvement in the mean DHI score. Both SEM and BDE were well tolerated, with a few minor complications, such as transient dizziness and nausea.
Conclusion:
Both SEM and BDE are effective for treating posterior canal BPPV. Although there was no significant resolution of the vertigo, there was a reduction in its intensity and a perceived decrease in its negative impact on daily life.
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