title: Effectiveness of the Epley's maneuver performed in primary care to treat posterior canal benign paroxysmal positional vertigo: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Vertigo is a common medical condition with a broad spectrum of diagnoses which requires an integrated approach to patients through a structured clinical interview and physical examination. The main cause of vertigo in primary care is benign paroxysmal positional vertigo (BPPV), which should be confirmed by a positive D-H positional test and treated with repositioning maneuvers. The objective of this study is to evaluate the effectiveness of Epley's maneuver performed by general practitioners (GPs) in the treatment of BPPV.
  
  
  METHODS
  This study is a randomized clinical trial conducted in the primary care setting. The study's scope will include two urban primary care centers which provide care for approximately 49,400 patients. All patients attending these two primary care centers, who are newly diagnosed with benign paroxysmal positional vertigo, will be invited to participate in the study and will be randomly assigned either to the treatment group (Epley's maneuver) or to the control group (a sham maneuver). Both groups will receive betahistine. Outcome variables will be: response to the D-H test, patients' report on presence or absence of vertigo during the previous week (dichotomous variable: yes/no), intensity of vertigo symptoms on a Likert-type scale in the previous week, total score on the Dizziness Handicap Inventory (DHI) and quantity of betahistine taken.
  
  
  CONCLUSIONS
  Positive results from our study will highlight that treatment of benign paroxysmal positional vertigo can be performed by trained general practitioners (GPs) and, therefore, its widespread practice may contribute to improve the quality of life of BPPV patients.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01969513.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Ballve Moreno
authors.forename: Ricard
authors.initials: R
authors.lastname: Carrillo Muñoz
authors.forename: Iván
authors.initials: I
authors.lastname: Villar Balboa
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Rando Matos
authors.forename: Olga Lucia
authors.initials: OL
authors.lastname: Arias Agudelo
authors.forename: Asha
authors.initials: A
authors.lastname: Vasudeva
authors.forename: Olga
authors.initials: O
authors.lastname: Bigas Aguilera
authors.forename: Jesús
authors.initials: J
authors.lastname: Almeda Ortega
authors.forename: Alicia
authors.initials: A
authors.lastname: Capella Guillén
authors.forename: Clara Johanna
authors.initials: CJ
authors.lastname: Buitrago Olaya
authors.forename: Xavier
authors.initials: X
authors.lastname: Monteverde Curto
authors.forename: Estrella
authors.initials: E
authors.lastname: Rodero Perez
authors.forename: Carles
authors.initials: C
authors.lastname: Rubio Ripollès
authors.forename: Pamela Catalina
authors.initials: PC
authors.lastname: Sepulveda Palacios
authors.forename: Noemí
authors.initials: N
authors.lastname: Moreno Farres
authors.forename: Anabella María
authors.initials: AM
authors.lastname: Hernández Sánchez
authors.forename: Carlos
authors.initials: C
authors.lastname: Martin Cantera
authors.forename: Rafael
authors.initials: R
authors.lastname: Azagra Ledesma
mesh_terms: D065635:Benign Paroxysmal Positional Vertigo / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001621:Betahistine / Q000627:therapeutic use; D002985:Clinical Protocols; D058005:General Practitioners; D017442:Histamine Agonists / Q000494:pharmacology; D006801:Humans; D026741:Physical Therapy Modalities; D011320:Primary Health Care / Q000379:methods*; D012107:Research Design; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D019037:Urban Health Services
chemical_list: D017442:Histamine Agonists; D001621:Betahistine