BPPV With CRP: Single Versus Multiple Cycles

Study Overview
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Brief Summary
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Unilateral posterior canal benign paroxysmal positional vertigo (BPPV) cases will be randomized to treat with single or multiple cycles of canalith repositioning procedure.The treatment outcomes will be assessed at 7th and 28th days.

Detailed Description
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Patients present with brief episodes of vertigo will be evaluated by Dix-Hallpike test. Cases with positive Dix-Hallpike test, unilateral, posterior canal, will be randomized with block of four. Either single or multiple cycles of canalith repositioning procedure will be performed. Four treatment outcomes will be blindly assessed at 7 and 28 days.

Official Title
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Comparison of the Treatment Outcomes of Posterior Canal Benign Paroxysmal Positional Vertigo (BPPV) With Canalith Repositioning Procedure (CRP): Single Versus Multiple Cycles

Conditions
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Benign Paroxysmal Positional Vertigo (BPPV)

Intervention / Treatment
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* Procedure: Canalith repositioning procedure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Recurrent episodes of vertigo 15 years of age or older Positive Dix-Hallpike test: unilateral, posterior canal Exclusion Criteria: Received vestibular suppressant within 6 hours With other diseases or conditions cause of vertigo or central nervous system disease With diseases or conditions contraindicate for Dix-Hallpike test or CRP eg: cervical spine disease, back/ neck stiffness, retinal detachment Positive Dix-Hallpike test: bilateral, other canals Complications from CRP eg: nausea, vomiting, canalith jam Cannot read the questionaire

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Single cycle<br>single cycle of canalith repositioning procedure | Procedure: Canalith repositioning procedure<br>* Canalith repositioning procedure; single or multiple cycles<br>* Other names: Epley's maneuver;|
| Experimental: multiple cycles of CRP<br>multiple cycles of canalith repositioning procedure CRP will be stopped if 1) no nystagmus and vertigo in all positions 2) complications exited 3) stable nystagmus in the 2 last cycles | Procedure: Canalith repositioning procedure<br>* Canalith repositioning procedure; single or multiple cycles<br>* Other names: Epley's maneuver;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dix-Hallpike test (DHT) | percentage of negative DHT between single and multiple cycles | At 7th day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dizziness handicap inventory (DHI) | total score in the questionaire | compare to the first visit at 7th between single and multiple cycles | 
| Dizziness handicap inventory (DHI) | total score in the questionaire | compare to the first visit at 28th day between single and multiple cycles | 
| Subjective symptoms | Asking the patient's symptom: Improve, same, worse | Improvement of the symptoms compare to the first visit at 7th day between single and multiple cycles | 
| Subjective symptoms | Asking the patient's symptom: Improve, same, worse | Improvement of the symptoms compare to the first visit at 28th day between single and multiple cycles | 
| Loss of balance | 5 levels Level 1: Able to continue daily activities without any helps. Level 2: Able to continue daily activities without any helps except complicated activities such as riding a bicycle, walking on counterpoise or scaffolding. Level 3: Not able to continue daily activities without help excepts simple activities such as self-care, housework, walking, or being a passenger in a vehicle Level 4: Not able to continue daily activities alone without help except self-care Level 5 Not able to continue daily activities alone without help except self-care without ambulation. Need to stay only in a house or a living place. (From: The Royal college of Otolaryngologists head and neck surgeons of Thailand, and social security office of thailand) | compare to the first visit at 7th between single and multiple cycles | 
| Loss of balance | 5 levels Level 1: Able to continue daily activities without any helps. Level 2: Able to continue daily activities without any helps except complicated activities such as riding a bicycle, walking on counterpoise or scaffolding. Level 3: Not able to continue daily activities without help excepts simple activities such as self-care, housework, walking, or being a passenger in a vehicle Level 4: Not able to continue daily activities alone without help except self-care Level 5 Not able to continue daily activities alone without help except self-care without ambulation. Need to stay only in a house or a living place. (From: The Royal college of Otolaryngologists head and neck surgeons of Thailand, and social security office of thailand) | compare to the first visit at 28th day between single and multiple cycles | 
| Dix-Hallpike test (DHT) | percentage of negative DHT between single and multiple cycles | At 28th day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Canalith repositioning procedure (CRP), BPPV