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Testing the Epley Maneuver for Treating Dizziness in the Emergency Department: A Randomized Study
Sponsor: American University of Beirut Medical Center
Summary
The goal of this randomized controlled trial is to evaluate the efficacy of the Epley maneuver versus a sham maneuver in treating patients presenting to the emergency department (ED) with BPPV. The main questions that the study aims to answer are: * What is the mean difference in Dizziness Handicap Inventory (DHI) scores between patients receiving the Epley maneuver and those receiving the sham maneuver 3 days after enrollment? * What is the immediate response (using a 0-10-point Likert scale) of patients in each arm of the study? * What is the proportion of patients who, despite agreeing to participate, were unable to complete the full Epley maneuver due to symptom severity? Researchers will compare the Epley maneuver arm to the sham maneuver arm to see if the Epley maneuver is more effective in reducing BPPV symptoms. Participants will: * Undergo either the Epley maneuver or a sham maneuver. * Complete the Dizziness Handicap Inventory (DHI) questionnaire at baseline and 3 days post-discharge. * Patients with insufficient improvement in the sham maneuver group will receive a rescue Epley maneuver. * Have their vertigo severity assessed using a 0-10 point Likert scale at baseline, immediately and post-maneuver.
Official title: Evaluating the Efficacy of Epley Maneuver in the Treatment of Benign Paroxysmal Positional Vertigo in the Emergency Department: A Randomized Controlled Trial.
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
118
Start Date
2025-09-01
Completion Date
2026-08-22
Last Updated
2025-08-08
Healthy Volunteers
No
Interventions
Epley Maneuver
The patient's head is turned 45 degrees towards the side that caused the most nystagmus or reproduced their initial symptoms. The patient is then laid down with their head hanging over the edge of the bed. After that, the head will be rotated 90 degrees in the opposite direction, with the head remaining in a dependent position. The patient is then asked to roll onto their side with their head facing downward. They are then brought back to a sitting position and the head is moved forward 45 degrees. Each position is held until the vertigo and/or nystagmus subsides or for at least 30 seconds
Sham maneuver
This control maneuver will involve coordinated movements of the hands and legs, while excluding any head movement. Patients will be at first in a sitting position with both feet on the ground and both hands placed on the thighs and then they will be asked to lift both hands off the thighs, keeping the arms extended. They will then be asked to return to their initial upright sitting position. Patients will then raise their right foot off the ground while keeping the left one planted on the ground. It will be an alternating movement between lifting the right and left feet while maintaining a smooth and well- controlled rhythm for 90 seconds.