What is EPLEY MANEUVER and How to Perform Epley Maneuver at Home
Channel: Fitness Freak
Date: 2019-11-26

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What is EPLEY MANEUVER? What does EPLEY MANEUVER mean? EPLEY MANEUVER meaning - EPLEY MANEUVER definition - EPLEY MANEUVER explanation.

Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license.

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The Epley maneuver or repositioning maneuver is a maneuver used to treat benign paroxysmal positional vertigo (BPPV) of the posterior or anterior canals. It works by allowing free-floating particles from the affected semicircular canal to be relocated, using gravity, back into the utricle, where they can no longer stimulate the cupula, therefore relieving the patient of bothersome vertigo. It is often performed by a medical doctor, occupational therapist, audiologist, physical therapist, osteopath or chiropractor after confirmation of a diagnosis of BPPV using the Dix-Hallpike test and has a reported success rate of between 90–95%. This maneuver was developed by Dr. John Epley and Dominic W. Hughes, Ph.D. and first described in 1980. Physiotherapists, osteopaths and some chiropractors now use a version of the maneuver called the "modified" Epley that does not include vibrations of the mastoid process originally indicated by Epley and Hughes, as they have since been shown not to improve the efficacy of the treatment.

The following sequence of positions describes the Epley maneuver:

1. The patient begins in an upright sitting posture, with the legs fully extended and the head rotated 45 degrees towards the side in the same direction that gives a positive Dix–Hallpike test.
2. The patient is then quickly and passively forced down backward by the clinician performing the treatment into a supine position with the head held approximately in a 30-degree neck extension (Dix-Hallpike position) and still rotated to the same.
3. The clinician observes the patient's eyes for “primary stage” nystagmus.
4. The patient remains in this position for approximately 1–2 minutes.

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5. The patient's head is then rotated 90 degrees in the opposite direction so that the opposite ear faces the floor, all while maintaining the 30-degree neck extension.
6. The patient remains in this position for approximately 1–2 minutes.
7. Keeping the head and neck in a fixed position relative to the body, the individual rolls onto their shoulder, rotating the head another 90 degrees in the direction that they are facing. The patient is now looking downwards at a 45-degree angle.
8. The eyes should be immediately observed by the clinician for “secondary stage” nystagmus and this secondary stage nystagmus should be in the same direction as the primary stage nystagmus. The patient remains in this position for approximately 1–2 minutes.
9. Finally, the patient is slowly brought up to an upright sitting posture, while maintaining the 45-degree rotation of the head.
10. The patient holds a sitting position for up to 30 seconds.

The entire procedure may be repeated two more times, for a total of three times.

During every step of this procedure, the patient may experience some dizziness.

Following the treatment, the clinician may provide the patient with a soft collar, often worn for the remainder of the day, as a cue to avoid any head positions that may once again displace the otoconia. The patient may be instructed to be cautious of bending over, lying backward, moving the head up and down, or tilting the head to either side. Patients should sleep semi-recumbent for the next two nights. This means sleeping with the head halfway between being flat and upright (at a 45-degree angle). This is most easily done by using a recliner chair or by using pillows arranged on a couch. The soft collar is removed occasionally. When doing so, the patient should be encouraged to perform horizontal movements of the head to maintain a normal neck range of motion.

It is important to instruct the patient that horizontal movement of the head should be performed to prevent stiff neck muscles.


This video is originally posted by The Audiopedia with Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license.


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