title: A safe-repositioning maneuver for the management of benign paroxysmal positional vertigo: Gans vs. Epley maneuver; a randomized comparative clinical trial.
abstract: Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. Some repositioning maneuvers have been described for its management. The aim of this study was comparing the therapeutic effect of Epley and Gans maneuvers in BPPV. This randomized clinical trial was performed from September to December 2015. 73 patients with true vertigo diagnosed as BPPV enrolled the study. They randomly assigned in quadripartite blocks to modified Epley maneuver group (E) or Gans maneuver group (G). 1 day and 1 week after intervention, the objective and subjective responses to treatment were assessed. Statistical analysis was performed using the Chi-square test and regression model in the SPSS software version 21. Thirty patients enrolled each group with a mean age of 46.9 ± 13.4 (E group) and 46.7 ± 7.5 year (G group). 23.3 % of E group and 26.7 % of G group were men (p = 0.766). In E and G groups in the first day, subjective outcomes revealed 86.7 and 60 % rate of success (p = 0.02); and 86.7 and 56.7 % of patients exhibited objective improvement, respectively (p = 0.01). After 1 week, the subjective and objective outcomes revealed improvement among 70 % of E group and 46.7 % of G group (p = 0.067). The only complication with significant difference was cervical pain with a higher rate in E group (23.3 vs. 0.0 %, p = 0.005). These results revealed the similar long-term efficacy of Epley and Gans maneuver for the treatment of BPPV. Cervical pain was most frequent complication of Epley maneuver.
authors.affiliation: Neurology Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran.
authors.forename: Alia
authors.initials: A
authors.lastname: Saberi
authors.affiliation: Rino-sinus Research Center, Guilan University of Medical Sciences, Rasht, Guilan, Iran. drshadmannemati_ent@yahoo.com.
authors.forename: Shadman
authors.initials: S
authors.lastname: Nemati
authors.affiliation: Ophthalmology Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Salah
authors.initials: S
authors.lastname: Sabnan
authors.affiliation: Neurology Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Mollahoseini
authors.affiliation: Biostatistics Department, Faculty of Nursery, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Kazemnejad
mesh_terms: D000328:Adult; D065635:Benign Paroxysmal Positional Vertigo / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000517:prevention & control; D056888:Patient Positioning / Q000379:methods*; D026741:Physical Therapy Modalities; D011187:Posture; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology / Q000517:prevention & control*
keywords: Benign paroxysmal positional vertigo; Complication; Efficacy; Epley maneuver; Gans maneuver; Repositioning maneuver