Rotational Chair vs. Manual Maneuvers for Non-Complex BPPV: A Prospective Randomized Study

To evaluate the clinical efficacy and diagnostic precision of the Thomas Richard Vitton (TRV) chair compared to conventional maneuvers in uncomplicated Benign Paroxysmal Positional Vertigo (BPPV), identifying risk factors for recurrence and impact on quality of life.

A prospective, randomized, open-label study was conducted. 102 patients were assigned to TRV chair or manual maneuvers. Clinical resolution, number of maneuvers, and recurrences were monitored over a 12-month follow-up. Quality of life was assessed via dizziness handicap inventory (DHI) and visual analog scale (VAS).

Eighty-nine patients completed follow-up (TRV = 44; manual = 45). No significant differences were found between groups in mean maneuvers for resolution (TRV: 2.25 ± 1.78; manual: 1.82 ± 1.23; p = 0.190). Both groups showed progressive reductions in DHI scores (TRV: 47.2 ± 25.1-10.6 ± 18.6; manual: 41.4 ± 22.2-11.6 ± 18.2; p < 0.001) and VAS scores (TRV: 5.3 ± 2.4-0.86 ± 1.4; manual: 4.3 ± 2.3-0.86 ± 1.4; p < 0.001), with no inter-group differences (p > 0.05). Notably, a trend toward faster resolution was observed in patients over 65 treated with the TRV chair. Advanced age and head trauma predicted increased maneuver requirements. Osteoporosis and prior BPPV episodes were associated with higher recurrence (p = 0.002). An inverse correlation was found between initial episode duration and time to first recurrence (ρ = -0.539, p = 0.005).

For uncomplicated BPPV, mechanical rotational chairs offer comparable efficacy and quality-of-life improvement to manual maneuvers. While not statistically superior for the general population, the TRV chair is a valuable tool for patients with mobility constraints.