Is it important to restrict head movement after Epley maneuver?

Ganança, Fernando Freitas; Simas, Ricardo; Ganança, Maurício Malavasi; Korn, Gustavo Polacow; Dorigueto, Ricardo Schaffeln

doi:10.1016/s1808-8694(15)31246-5

Cited by 15 publications

(17 citation statements)

References 16 publications

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“…With this aim in mind, other classical restrictions have been stated, such as to avoid sudden head movements, to wear a cervical collar and to avoid lying on the affected side ( Cakir et al., 2006 ). Several studies have been conducted to clarify this topic, most of them failing to show a benefit from postural restrictions ( Casqueiro et al., 2008 , De Stefano et al., 2011 , Devaiah and Andreoli, 2010 , Fyrmpas et al., 2009 , Ganança et al., 2005 , Marciano and Marcelli, 2002 , Moon et al., 2005 , Papacharalampous et al., 2012 , Roberts et al., 2005 ). In a Cochrane review ( Hunt et al., 2012 ), the conclusion is that there is a statistically significant effect of post-Epley postural restrictions in comparison to Epley manoeuvre alone (Semont manoeuvre was not evaluated in this study), but the improvement in treatment efficacy is very small.…”

Section: Treatment Of the Posterior Canal Canalolithiasis (Pc-bppv)mentioning

confidence: 99%

Treatment of benign paroxysmal positional vertigo. A clinical review

Pérez-Vázquez

Franco‐Gutiérrez

2017

Journal of Otology

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Benign paroxysmal positional vertigo (BPPV) is the most frequent episodic vestibular disorder. It is due to otolith rests that are free into the canals or attached to the cupulas. Well over 90% of patients can be successfully treated with manoeuvres that move the particles back to the utriculus. Among the great variety of procedures that have been described, the manoeuvres that are supported by evidenced-based studies or extensive series are commented in this review. Some topics regarding BPPV treatment, such as controlling the accuracy of the procedures or the utility of post-manoeuvre restrictions are also discussed.

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Section: Treatment Of the Posterior Canal Canalolithiasis (Pc-bppv)mentioning

confidence: 99%

Treatment of benign paroxysmal positional vertigo. A clinical review

Pérez-Vázquez

Franco‐Gutiérrez

2017

Journal of Otology

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“…In order to analyze the success of the treatment of BPPV, it is imperative that the Dix-Hallpike test be negative as it means thatthe absence of nystagmus occurs by designating the resolution for the semicircular canal treated 13 . Ganança et al, in a prospective clinical study proposes the repetition of the maneuver for negativity a week after the treatment 14 . On the other hand, Barreto states that although some authors defend the period of a week,the reevaluation can be made after72 hours 44 and yet et al analyzed the negative of the maneuver 1 to 24 hours after the repositioning maneuver treatment 45 .…”

Section: Discussionmentioning

confidence: 99%

Applicability of the Dix-Hallpike test on benign paroxysmal positional vertigo: literature review

et al. 2019

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Objetivo: Analisar a aplicabilidade da manobra de Dix-Hallpike sobre a VPPB como método diagnóstico para os canais semicirculares, bem como sua sensibilidade. Métodos: realizou-se revisão bibliográfica utilizando as seguintes bases de dados de sourcing: LILACS, PubMed, SCIELO procurando por artigos publicados em português, inglês e espanhol. Foram utilizados os seguintes descritores da estratégia de busca: vertigem, vestibulopatias e técnicas de fisioterapia respiratória, sendo incluídas publicações entre os anos de 2000 e 2017. Resultados: os resultados do trabalho foram apresentados por meio de tabela e fluxograma sinóptico. Conclusão: Ainda há controvérsias quanto à sua sensibilidade aos canais anteriores e laterais, mesmo que a manobra, não apresente sensibilidade de 100%, seu grau de proximidade proporciona segurança no diagnóstico da VPPB.

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“…On the contrary, Cakir et al reported that the difference between restricted and non-restricted groups in the number of maneuvers required for treatment was statistically significant [18]. Some studies also showed a better outcome for patients with postural restrictions but did not detect a statistically significant difference due to small sample sizes [13], [19]–[21]. A recent meta-analysis included 9 relevant articles and concluded that there were no significant differences between patients instructed to restrict their posture after the repositioning maneuver and patients allowed to move freely after a repositioning maneuver with regard to the presence or absence of post-maneuver symptoms[23].…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, Cakir et al reported that the difference between restricted and non-restricted groups in the number of maneuvers required for treatment was statistically significant [18]. Some studies also showed a better outcome for patients with postural restrictions but did not detect a statistically significant difference due to small sample sizes [13], [19]–[21]. However, patients' compliance to postural restriction has not been seriously considered in most of these studies and may affect their results.…”

Section: Introductionmentioning

confidence: 99%

Impact of Postmaneuver Sleep Position on Recurrence of Benign Paroxysmal Positional Vertigo

Tian

Han

et al. 2013

PLoS ONE

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BackgroundThe necessity of postural restriction to patients suffering from benign paroxysmal positional vertigo is controversial.ObjectiveTo investigate the impact of the sleep position after the repositioning maneuver on BPPV recurrence.Methods150 unilateral BPPV patients who were treated by repositioning maneuver were distributed into two groups. The patients in group A were instructed to sleep in a semi-sitting position at an angle of approximately 30 degrees and refrain from sleeping on their BPPV affected side for one week. The patients in group B were told to sleep in any preferred position. The comparison of recurrence rates according to different actual sleep positions in one week and one month was performed.ResultsThere was a statistically significant correlation between the sleeping side and the side affected by BPPV. Without instructions on postural restriction, most patients (82.9%, 73/88) avoided sleeping on their affected side. The patients sleeping on their affected side had a higher recurrence rate (35.3%) than ones sleeping in other positions in the first week after the repositioning maneuver (p<0.05, Chi-square test and Fisher's exact test). The patients sleeping randomly in following 3 weeks had a lower recurrence rate than ones sleeping in other position (p<0.05, Fisher's exact test).ConclusionsBPPV patients had a poor compliance to postural instructions. The habitual sleep side was associated with the side affected by BPPV. The patients sleeping on their affected side had a higher recurrence rate than those sleeping in other positions in first week after the repositioning maneuver.

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Is it important to restrict head movement after Epley maneuver?

Abstract: The use of postural restrictions in patients with benign paroxysmal positional vertigo of posterior canal didn't interfere in their clinical evaluation, one week after a unique Epley maneuver.

Cited by 15 publications

References 16 publications

Treatment of benign paroxysmal positional vertigo. A clinical review

Treatment of benign paroxysmal positional vertigo. A clinical review

Applicability of the Dix-Hallpike test on benign paroxysmal positional vertigo: literature review

Impact of Postmaneuver Sleep Position on Recurrence of Benign Paroxysmal Positional Vertigo

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