Epley Manoeuvre’s Efficacy for Benign Paroxysmal Positional Vertigo (BPPV) in Primary-Care and Subspecialty Settings: A Systematic Review and Meta-Analysis
BMC Primary Care
Saishoji, Y., Yamamoto, N., et al. (2023).
BMC Primary Care, 24(1), 262.
This systematic review with meta-analysis compares the effects of the Epley maneuver (EM) provided in different settings (i.e., primary care and subspecialty settings) in individuals with benign paroxysmal positional vertigo (BPPV).
No funding received
From database inception to January 2022
Randomized controlled trials
27
The EM reduced subjective and objective symptoms of BBPV regardless of whether it was delivered in primary care or subspecialty settings. Patient outcomes did not differ based on the client's age or the duration of BPPV symptoms before treatment. Specific findings for the use of the EM in subspeciality settings include: <br />
<ul>
<li><span style="color: #333333;">reduced subjective symptoms of BPPV (RR = 2.42; 16 studies; Low Certainty of Evidence);</span></li>
<li><span style="color: #333333;">increased negative findings on the Dix–Hallpike test (RR = 1.81; 16 studies; Low Certainty of Evidence);</span></li>
<li><span style="color: #333333;">slightly reduced objective symptoms of BPPV (RR = 1.69; 1 study; Low Certainty of Evidence);</span></li>
<li><span style="color: #333333;">an uncertain effect on Dizziness Handicap Index Screening (DHI-S) scores (mean difference = -8.24; 2 studies; Very Low Certainty of Evidence); and</span></li>
<li><span style="color: #333333;">an uncertain effect on adverse events (1 study). </span></li>
</ul>
<span style="color: #333333;">Limitations to these findings included the lack of long-term data, the inability to conduct subgroup analysis, the absence of sensitivity analysis for objective findings, and a lack of investigation of the potential impacts of provider training on treatment outcomes. Additional large-scale, high-quality research is needed.</span>
