title: Effectiveness of treatments for benign paroxysmal positional vertigo of the posterior canal.
abstract: OBJECTIVE
  To determine which common, nonpharmacological, nonsurgical treatments are most effective for treatment of benign paroxysmal positional vertigo (BPPV).
  
  
  METHODS
  Prospective, randomized, sham-controlled.
  
  
  METHODS
  Patients (n = 124) with BPPV of the posterior semicircular canal.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Random assignment to one of five groups: modified canalith repositioning maneuver (CRP), modified liberatory maneuver (LM), sham maneuver, Brandt and Daroff's exercise, and vertigo habituation exercises. Subjects received a standard educational lecture about BPPV and the purpose of the intervention. No vestibular-suppressant medication or special instructions for head positioning were used. Post-tests were given at 1 week after treatment and at approximately 3 months and 6 months later.
  
  
  METHODS
  Vertigo intensity and frequency.
  
  
  RESULTS
  Multilevel analyses showed that vertigo decreased significantly after LM, CRP, and Brandt-Daroff exercise; those three groups did not differ significantly. The habituation group did not differ from sham, Brandt-Daroff, LM, or CRP groups. Changes in scores were maintained throughout the 6-month follow-up period.
  
  
  CONCLUSIONS
  LM, CRP, and exercises are all effective interventions; patient education plus the sham maneuver, however, had some beneficial effect. These results support two possible mechanisms of BPPV: displaced otoconia and a neural mechanism affecting interpretation of semicircular canal signals.
authors.affiliation: Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA. hcohen@bcm.tmc.edu
authors.forename: Helen S
authors.initials: HS
authors.lastname: Cohen
authors.forename: Kay T
authors.initials: KT
authors.lastname: Kimball
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D016896:Treatment Outcome; D014717:Vertigo / Q000628:therapy*