Clinical trial NCT05575362: Comparison of Epley Maneuver and COW Thorne Cooksey Exercise With Half Somersault Maneuver in BPPV
Official title: Comparison of Epley Maneuver and COW Thorne Cooksey Exercise With Half Somersault Maneuver in Patients of BPPV
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: BPPV
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2022-10-12
Enrollment: 32
Sex: ALL
Minimum age (years): 35
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Benign paroxysmal positional vertigo is a most common cause of peripheral vestibular pathology. BPPV may be characterized by sudden changes in the position of the head, such as lying down on one or both sides, looking right or left side .it can occurs either due to canalithiasis or cupulolithiasis, displacement of otoconia or calcium carbonate crystal into fluid filled semicircular canal which sends false signals to central nervous system causing nystagmus and vertigo. BPPV is a self limiting condition characterized by episodic vertigo and nystagmus of brief duration which resolves spontaneously.

Detailed description: BPPV is treated using canalith repositioning procedures, the most common of which is the Epley's maneuver (EM), half somersault exercises, Brandt Daroff exercise, Semont maneuver, vestibular habituation exercises, balance and eye exercises. In addition to the maneuvers, simple daily program Caw Thorne -Cooksey exercise were instructed to perform by participants to ensure clearance of the otoconia and facilitate full resolution of vertigo symptoms. These vestibular exercises involve eye, head and body movements in different directions to provoke vestibular system. It promote recovery and reduce symptoms of dizziness, unsteadiness , balance impairment and improves activity of daily living. The Otolaryngologist Caw Thorne and Cooksey develops this exercise programme in order to rehabilitate the soldier with chronic dizzeness and brain trauma. A study concluded by Ramanathan et al 2019 that Caw Thorne -Cooksey habituation exercises along with Brandt-Daroff exercises is more effective in treatment of vertigo among posterior canal BPPV subject . Caw Thorne and Cooksey exercise improves balance in old age individuals. Caw Thorne and Cooksey exercise are habituation exercise. These movements provoke patients symptoms and patients repeat these exercises until unless they no longer respond to adverse effects of these exercises .

Eligibility criteria: Inclusion Criteria:

* • Patients with Posterior canal BPPV.

  * Patients with recurrent episodes of vertigo for 3 months.
  * Age group 35-65years.
  * Dix-Hall-pike test positive.
  * Both gender

Exclusion Criteria:

* • Migraine related dizziness and Anxiety disorder

  * Dix hallpike test negetive
  * Other vestibular conditions are: Acoustic neuroma, Labyrinthitis, Vestibular hypofunction, Meniere's disease.
  * Any cervical pathology,
  * Visual impairment,
  * CNS Pathology:causing dizziness and vertigo
  * Other pathologies which may affect balance

Primary outcomes:
measure: Dizziness Handicap Inventory
timeFrame: Change from baseline, to 3rd session, 6th session and after 1 month
measure: vestibular activity participation scale
timeFrame: Change from baseline, to 3rd session, 6th session and after 1 month
Secondary outcomes:
measure: Berg balance scale
timeFrame: Change from baseline, to 3rd session, 6th session and after 1 month
Other outcomes:
Locations:
city: Islamabad
country: Pakistan
facility: Misbah
state: Punjab
Study officials:
affiliation: Riphah International University Islamabad
name: Misbah Ghous, MS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Chen CC, Cho HS, Lee HH, Hu CJ. Efficacy of Repositioning Therapy in Patients With Benign Paroxysmal Positional Vertigo and Preexisting Central Neurologic Disorders. Front Neurol. 2018 Jun 29;9:486. doi: 10.3389/fneur.2018.00486. eCollection 2018.
citation: Desai DS, Chauhan AS, Trivedi MN. Role of modified Epley's maneuver and Brandt-Daroff exercises in treatment of posterior canal BPPV: a comparative study. Int J Physiother Res. 2015;3(3):1059-64.