title: Randomized clinical trial for apogeotropic horizontal canal benign paroxysmal positional vertigo.
abstract: OBJECTIVE
  To determine the immediate and long-term therapeutic efficacies of Gufoni and head-shaking maneuvers in apogeotropic type of benign paroxysmal positional vertigo involving the horizontal semicircular canal (HC-BPPV), a randomized, prospective, sham-controlled study was conducted.
  
  
  METHODS
  In 10 nationwide dizziness clinics in Korea, 157 consecutive patients (95 women, age range: 18-89 years, mean age ± SD = 59.9 ± 13.6) with apogeotropic HC-BPPV were randomized to Gufoni (n = 52), head-shaking (n = 54), or sham maneuver (n = 51). For Gufoni maneuver, patients underwent ipsilesional side-lying and upward head-turn for migration of the debris toward the vestibule. Immediate responses were determined within 1 hour after a maximum of 2 trials of each maneuver and in the following day. The patients also had weekly follow-ups for 1 month after the initial maneuver.
  
  
  RESULTS
  After a maximum of 2 maneuvers on the initial visit day, Gufoni (38/52, 73.1%) and head-shaking (33/53, 62.3%) maneuvers showed better responses than the sham maneuver (17/49, 34.7%). The cumulative therapeutic effects were also better with Gufoni (p < 0.001) and head-shaking (p = 0.026) maneuvers compared with the sham maneuver. However, therapeutic efficacies did not differ between the Gufoni and head-shaking groups in terms of both immediate (p = 0.129) and long-term (p = 0.239) outcomes.
  
  
  CONCLUSIONS
  Using a prospective randomized trial, we demonstrated that the Gufoni and head-shaking maneuvers are effective in treating apogeotropic HC-BPPV.
  
  
  METHODS
  This study provides Class II evidence that Gufoni and head-shaking maneuvers are effective in treating apogeotropic horizontal BPPV up to 1 month after initial treatment.
  
  
  BACKGROUND
  NCT00810641.
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
authors.forename: J-S
authors.initials: JS
authors.lastname: Kim
authors.forename: S-Y
authors.initials: SY
authors.lastname: Oh
authors.forename: S-H
authors.initials: SH
authors.lastname: Lee
authors.forename: J-H
authors.initials: JH
authors.lastname: Kang
authors.forename: D U
authors.initials: DU
authors.lastname: Kim
authors.forename: S-H
authors.initials: SH
authors.lastname: Jeong
authors.forename: K-D
authors.initials: KD
authors.lastname: Choi
authors.forename: I-S
authors.initials: IS
authors.lastname: Moon
authors.forename: B-K
authors.initials: BK
authors.lastname: Kim
authors.forename: H J
authors.initials: HJ
authors.lastname: Oh
authors.forename: H J
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D005081:Exercise Therapy / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D019416:Head Movements; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome; D014717:Vertigo / Q000453:epidemiology* / Q000534:rehabilitation*