Effectiveness of Forced Prolonged Position for Geotropic Horizontal Canal BPPV: A Systematic Review
Physical Therapy Reviews
Kinne, B. L., Anderson, H. J., et al. (2023).
Physical Therapy Reviews, 28(3), 188-194.
This systematic review investigates the effects of the forced prolonged position (FPP) maneuver on vertigo and nystagmus symptoms in individuals with geotropic horizontal canal benign paroxysmal positional vertigo (BPPV).
No funding received
From database inception to 2022
Oxford Centre for Evidence-Based Medicine Level 2 and 3 evidence (i.e., randomized trials, observational studies with dramatic effect, or non-randomized controlled cohort/follow-up studies). Excludes Level 4 and 5 evidence (i.e., case-series, case-control studies, historically controlled studies, or mechanism-based reasoning)
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For individuals with geotropic horizontal canal BPPV, the FPP maneuver may be a highly effective treatment used either independently or in combination with other maneuvers. Studies show that FPP has a 73-100% rate for resolving symptoms of vertigo and/or nystagmus. Compared to other positioning maneuvers, FPP showed:<br />
<ul>
<li>significantly greater efficacy than the Baloh 360-degree maneuver;</li>
<li>slightly higher efficacy than the Lempert 270-degree maneuver; and</li>
<li>no statistical difference in efficacy with the Gufoni maneuver.</li>
</ul>
This review included a limited number of low-quality studies that lacked follow-up data. Additional high-quality, rigorous research on the use of the FPP maneuver for geotropic horizontal canal BPPV is needed.
