Limits...
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.

Ballve Moreno JL, Carrillo Muñoz R, Villar Balboa I, Rando Matos Y, Arias Agudelo OL, Vasudeva A, Bigas Aguilera O, Almeda Ortega J, Capella Guillén A, Buitrago Olaya CJ, Monteverde Curto X, Rodero Perez E, Rubio Ripollès C, Sepulveda Palacios PC, Moreno Farres N, Hernández Sánchez AM, Martin Cantera C, Azagra Ledesma R - Trials (2014)

Bottom Line: 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.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.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.

View Article: PubMed Central - HTML - PubMed

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/design: 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.

Discussion: 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.

Trial registration: ClinicalTrials.gov Identifier: NCT01969513.

Show MeSH

Related in: MedlinePlus

Flow diagram of the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4043960&req=5

Figure 1: Flow diagram of the study.

Mentions: All patients with newly diagnosed BPPV, who attend our two primary care centers, will be potential participants in our clinical trial. Patients will be systematically recruited with the collaboration of the 26 GPs who work at the two participant primary care centers. Regardless the initial cause for the visit, if a GP suspects BPPV, he/she will check whether the patient meets the inclusion criteria and presents no exclusion criteria. Eligible participants will be informed of the possibility to take part in the trial and will be supplied with written information about the study. Those who accept to participate in the study will be given an appointment for the baseline visit, preferably within a week and no longer than ten days after. The recruitment period is expected to last two years (Figure 1).


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.

Ballve Moreno JL, Carrillo Muñoz R, Villar Balboa I, Rando Matos Y, Arias Agudelo OL, Vasudeva A, Bigas Aguilera O, Almeda Ortega J, Capella Guillén A, Buitrago Olaya CJ, Monteverde Curto X, Rodero Perez E, Rubio Ripollès C, Sepulveda Palacios PC, Moreno Farres N, Hernández Sánchez AM, Martin Cantera C, Azagra Ledesma R - Trials (2014)

Flow diagram of the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4043960&req=5

Figure 1: Flow diagram of the study.
Mentions: All patients with newly diagnosed BPPV, who attend our two primary care centers, will be potential participants in our clinical trial. Patients will be systematically recruited with the collaboration of the 26 GPs who work at the two participant primary care centers. Regardless the initial cause for the visit, if a GP suspects BPPV, he/she will check whether the patient meets the inclusion criteria and presents no exclusion criteria. Eligible participants will be informed of the possibility to take part in the trial and will be supplied with written information about the study. Those who accept to participate in the study will be given an appointment for the baseline visit, preferably within a week and no longer than ten days after. The recruitment period is expected to last two years (Figure 1).

Bottom Line: 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.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.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.

View Article: PubMed Central - HTML - PubMed

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/design: 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.

Discussion: 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.

Trial registration: ClinicalTrials.gov Identifier: NCT01969513.

Show MeSH
Related in: MedlinePlus