Comparison of Home-Based Exercise on the Posterior Canal Benign Paroxysmal Positional Vertigo Symptoms

Not Applicable

Completed

• Conditions: Benign Paroxysmal Positional Vertigo
• Interventions: Other: Brandt-Daroff Exercise; Other: Self Epley Manoeuvre

• Registration Number: NCT03230513
• Lead Sponsor: University of Malaya

Brief Summary

Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder in adults and the treatment of choice is by particle repositioning manoeuvres (PRM). This study aims to compare the treatment efficacy of two home-based exercises, self-Epley manoeuvre (SEM) and Brandt-Daroff exercise (BDE) in patients with posterior canal BPPV based on vertigo resolution, reduction of vertigo intensity, the Dizziness Handicap Inventory scores and the conversion of a positive to negative Dix-Hallpike test.

Detailed Description

Study Objective:

To compare the efficacy of the self-Epley manoeuvre to the Brandt-Daroff exercise in resolving vertigo symptoms in patients with unilateral posterior canal BPPV.

Study Design:

Single-blind randomized controlled study

Sample Size:

Fifty patients were recruited in the study and were divided with 25 patients in each treatment arm.

Study Method:

Patients who satisfy the inclusion criteria and have given informed consent were randomized into the 2 treatment groups. A dedicated physiotherapist will demonstrate the selected exercise (either SEM or BDE) and observed the patient performing the exercise twice to ensure the ability of the patient to perform it correctly at home. A diary was provided for the patients to chart the therapy sessions performed at home as well as a pamphlet with simple illustrated instructions of the chosen exercise. The patients were asked to perform the home-based exercise for 2 weeks.

Primary Outcome Measure

- Resolution of vertigo symptoms in patients with unilateral posterior canal BPPV.

Secondary Outcome Measures

* Vertigo resolution at 1 and 6 months;

* The conversion of positive to negative Dix-Hallpike test between both groups after 1 month;

* Vertigo intensity in unresolved vertigo patients at 1 \& 6 months;

* The Dizziness Handicap Inventory between both groups at 1 and 6 months.

Study Timeline

• Study Start: 2015-10-01
• Primary Completion: 2016-10-31
• Study Completion: 2017-05-01
• Status Verified: 2017-07
• Study First Submitted: 2017-07-24
• Study First Submitted QC: 2017-07-24
• Study First Posted: 2017-07-26
• Last Update Submitted: 2017-07-30
• Last Update Posted: 2017-08-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• patients who have had symptoms of vertigo for at least 1 week duration,
• patients with a documented positive Dix-Hallpike test on referral,
• patients with intact cognitive function and had the ability to communicate and understand instructions to perform a home-based exercise.

Exclusion Criteria

• patients with history of prior ear surgery,
• patients with orthopaedic or connective tissue disorder that impairs functional neck or trunk range of motion,
• patients with a significant neurological disorder or spinal cord damage, and
• patients who have been prescribed with home-based exercises for BPPV.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Brandt-Daroff Exercise	Brandt-Daroff Exercise	Brandt-Daroff Exercise.
Self Epley Manoeuvre	Self Epley Manoeuvre	Self Epley Manoeuvre.

Primary Outcome Measures

Name	Time	Method
Vertigo resolution	Assessed at 1 month and 6 months following initiation of home-based exercise.	Present or absent

Secondary Outcome Measures

Name	Time	Method
Conversion of a positive to negative Dix-Hallpike test	Assessed at 1 month following initiation of home-based exercise.	Positive or negative
Vertigo intensity	Assessed on first assessment during recruitment, at 1 month and 6 months following initiation of home-based exercise.	Patients were asked to rate the average severity or intensity of the vertigo episode in the previous one week based on a 1-to-5 Likert scale, with a scale of 5 implying the most intense or severe.
Dizziness Handicap Inventory	Assessed on first assessment during recruitment, at 1 month and 6 months following initiation of home-based exercise.	A 25 item questionnaire that encompasses 3 domains which are functional, physical and emotional. The scores are summed with maximum score of 100 and the higher the score, the greater the perceived handicap.