Rapid Systematic Review of the Epley Maneuver versus Vestibular Rehabilitation for Benign Paroxysmal Positional Vertigo.
To evaluate the effectiveness of the Epley maneuver compared with vestibular rehabilitation on patient-reported symptom relief and conversion of the Dix-Hallpike from positive to negative in patients with posterior benign paroxysmal positional vertigo (p-BPPV).



PubMed, Embase, and the Cochrane Library.



A systematic search was conducted. Studies reporting original study data were included. Relevance and risk of bias (RoB) of the selected articles were assessed. Studies with low relevance, high RoB, or both were excluded. For outcomes of interest, absolute risk differences and their 95% confidence intervals (CIs) were extracted.



A total of 373 unique studies were retrieved. Five of these satisfied the eligibility criteria. One study with low RoB and 3 studies with moderate RoB showed that the Epley maneuver is more effective than vestibular rehabilitation at 1-week follow-up with regard to patient-reported symptom relief and conversion of the Dix-Hallpike maneuver from positive to negative (risk differences range from 10% [95% CI, 30-47] to 55% [95% CI, 35-71]). There is inconsistent evidence for the effectiveness of the Epley maneuver compared with vestibular rehabilitation at 1-month follow-up. Most studies suggest that the Epley maneuver and vestibular rehabilitation are equally effective at 1-month follow-up.



The Epley maneuver is more effective in treating p-BPPV than vestibular rehabilitation at 1-week follow-up. There is inconsistent evidence for the effectiveness of the Epley maneuver compared with vestibular rehabilitation at 1-month follow-up.
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands ENT-research@umcutrecht.nl.
Inge
I
Wegner
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
Marlien E F
ME
Niesten
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Cornelis H
CH
van Werkhoven
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
Wilko
W
Grolman
D065635:Benign Paroxysmal Positional Vertigo / Q000534:rehabilitation*; D026241:Exercise Movement Techniques; D006801:Humans; D056888:Patient Positioning / Q000379:methods*; D026741:Physical Therapy Modalities
BPPV; CRP; Epley; rehabilitation therapy; systematic review; vertigo; vestibular therapy