Roll Maneuvers Versus Side-Lying Maneuvers for Geotropic Horizontal Canal BPPV: A Systematic Review
Physical Therapy Reviews
Kinne, B. L., Harless, M. G., et al. (2021).
Physical Therapy Reviews, 26(6), 439-446.
This systematic review explores the effects of side-lying and roll maneuvers in the treatment of geotropic horizontal canal benign paroxysmal positional vertigo (BPPV).
No funding received
From database inception to 2020
Randomized trials, observational studies with dramatic effect, non-randomized controlled cohort or follow-up studies
19
<p>Findings demonstrated the following rates of complete alleviation of geotropic horizontal canal BPPV in individuals following one treatment session incorporating side-lying and roll maneuvers:</p>
<ul>
<li><strong>Baloh 360-degree roll maneuver:</strong> 38.5-91.7% (eight studies);</li>
<li><strong>Gufoni maneuver:</strong> 60.9-100% (seven studies);</li>
<li><strong>Ichijo 120-degree roll maneuver:</strong> 93.5% (one study);</li>
<li><strong>Ichijo 90-degree roll maneuver:</strong> 82.6% (one study);</li>
<li><strong>Lempert 270-degree roll maneuver:</strong> 66.7-93.1% (five studies);</li>
<li><strong>Li quick repositioning maneuver:</strong> 61.7% (one study); and</li>
<li><strong>Tirelli 360-degree roll maneuver:</strong> 82.3% (one study).</li>
</ul>
<p>Of note, the Gufoni maneuver was the only side-lying maneuver represented within this review, and is noted to be preferable for individuals with limited mobility. Additionally, the Ichijo 90- and 120-degree roll maneuvers and the Li quick repositioning maneuver were noted to require less mobility than other roll maneuvers. Information regarding contraindications for each maneuver was limited, with the following possible contraindications noted:</p>
<ul>
<li><strong>Baloh 360-degree roll maneuver:</strong> individuals with limited mobility due to age-related changes, body habitus, arthritis, cervical issues, muscle stiffness, traumatic injury, etc.;</li>
<li><strong>Gufoni maneuver:</strong> recent cervical surgery or severe lumbar pain;</li>
<li><strong>Lempert 270-degree roll maneuver:</strong> recent cervical surgery or severe lumbar pain; and</li>
<li><strong>Tirelli 360-degree roll maneuver:</strong> whiplash injuries or cervical arthrosis.</li>
</ul>
<p>Limitations for this review included heterogeneity between included studies, reduced methodological rigor of included studies, small sample sizes, and limited evidence regarding each investigated maneuver. Further research is indicated.</p>
