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

José L. Ballve Moreno, Ricard Carrillo Muñoz, Iván Villar Balboa, Yolanda Rando Matos, Olga L. Arias Agudelo, Asha Vasudeva, Olga Bigas Aguilera, Jesús Almeda Ortega, Alicia Capella Guillén, Clara J. Buitrago Olaya, Xavier Monteverde Curto, Estrella Rodero Perez, Carles Rubio Ripollès, Pamela C. Sepulveda Palacios, Noemí Moreno Farres, Anabella M. Hernández Sánchez, Carlos Martin Cantera, Rafael Azagra Ledesma

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6 Citations (Scopus)


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.We will use descriptive statistics of all variables collected. Groups will be compared using the intent-to-treat approach and either parametric or nonparametric tests, depending on the nature and distribution of the variables. Chi-square test or Fisher's exact test will be conducted to compare categorical measures and Student's t-test or Mann-Whitney U-test will be used for intergroup comparison variables. 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. © 2014 Ballve Moreno et al.; licensee BioMed Central Ltd.
Original languageEnglish
Article number179
Publication statusPublished - 21 May 2014


  • Benign paroxysmal positional vertigo
  • Betahistine
  • Canalith repositioning procedure
  • Primary care
  • Randomized clinical trial


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