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“One of the key things about the maneuver is lying all the way back with the head way back, kind of on the end of a table,” said Dr. Reasons for inaccuracies included things such as patients turning their head more than 45 degrees, or the head not being extended back far enough. However, none of the videos included complete diagnostic information about BPPV. Most videos (82%) provided accurate time spent on each position. The researchers rated almost two thirds of the videos (64%) as accurate demonstrations of the maneuver. That video, along with 4 others, accounted for 85% of hits for all videos. The most widely viewed video (with 802,471 hits) was produced in 2008 by the Practice Parameter on BPPV of the American Academy of Neurology (AAN). The total number of hits for all videos was 2,755,607. Most seemed to have been made by healthcare providers, including physicians and physical therapists, but some were likely made by patients in their home. The videos appeared to come from a number of different sources, said Dr. Researchers also determined whether the videos included diagnostic information and were accurate in the time spent on each position of the maneuver (most should last at least 20 seconds). They categorized the videos as demonstrating guided treatment or self-treatment, and as showing the maneuver for right-sided BPPV, left-sided BPPV, or both. “There haven’t been that many studies looking at this, but every one of them suggests that this maneuver is underutilized.” It is possible that physicians recommend the maneuver but just do not record it, he said.Īfter performing a systematic search and selecting videos that demonstrated the entire Epley maneuver and that were available on YouTube up to August 30, 2011, researchers abstracted information from each video, including its duration, posting date, and number of views, and related comments from viewers. Kerber, however, this treatment is not widely used. “If you want to treat someone effectively, this is it.”Īccording to Dr. The maneuver has been proven effective in rigorous randomized trials and is included in guidelines on treating BPPV, said Dr. turning the head another 90 degrees so the patient is nearly in the face-down position (usually requires rolling over on the side), and.moving the head 90 degrees toward the unaffected side.lying back quickly with the head extended below the shoulders.turning the head 45 degrees toward the affected ear while in an upright position.
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The Epley maneuver involves a series of easy steps designed to move particles from the canal, including the following: A main symptom of BPPV is transient, positionally triggered dizziness. Kerber, MD, assistant professor of neurology at the University of Michigan Health System in Ann Arbor.Ī relatively common condition, BPPV is caused by freely moving particles called canaliths that are trapped in the semicircular canal of the inner ear. The study, published in the July 24 issue of Neurology, shows that 64% of 33 videos had correct information on how to perform the Epley maneuver, with most of the other videos having only minor deviations from the accepted approach, said lead author Kevin A. As the system operates on two axes, the clinician is able to precisely position the patient through a 360-degree range in order to assess and treat them.Video demonstrations of a common maneuver for managing benign paroxysmal positional vertigo (BPPV) are readily available on YouTube, and most are accurate depictions of the treatment, according to a new study. Infrared video goggles record the eye movements and specialist clinicians analyse the results to help diagnose and treat the dizziness. Patients are seated in a chair, secured with a harness and slowly moved to various positions. The Epley Omniax Positioning System has also successfully been used when a patient is unable to be assessed and treated in the conventional manner because of other medical conditions, for example arthritis, or larger body types. BPPV is the most common cause of dizziness. It is used to assess the characteristic abnormal eye movements (positional nystagmus) which can aid the most accurate assessment and treatment of Benign Paroxysmal Positional Vertigo (BPPV). This means they spend less time in hospital and can return to daily activities more quickly. It increases accuracy of diagnoses for people with balance disorders. The Epley Omniax Positioning System is one of only 34 in the world and only the second in Australia.