A randomized controlled trial comparing home-based modified Epley maneuver and Brandt-Daroff exercise for posterior canal benign paroxysmal positional vertigo symptoms.

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.