Investigations in Reproducibility of Positioning Manoeuvres for the Treatment of Benign Paroxysmal Positional Vertigo (BPPV) in Patients' Supplementary Self-Controlled Training

Introduction:

There is general agreement on the extraordinary value of physical repositioning and liberation manoeuvres for the treatment of Benign Paroxysmal Positional Vertigo (BPPV). Success rates of repositioning manoeuvres can be enhanced by patients performing these manoeuvres in a self-administered way. In these cases, patients seek guidance mostly by printed brochures or video instructions found on the internet. Their disadvantage lies in the need for understanding and memorizing/rehearsing the procedure as accurately as possible in order to take effect.

Methods:

We investigate the potential of a simple virtual reality (VR) environment with respect to guiding individuals by virtual anchor points in space which are consecutively addressed by the person performing body and head movements in a given order. We compare reproducibility of specific positions including head position angles given by VR to those obtained from instructions given in a hardcopy brochure. 16 individuals take part in a crossover trial (8 individuals: brochure → VR and further 8 individuals: VR → brochure).

Results:

According to first results, repositioning manoeuvre published by Epley is managed by non-professional individuals in a self-administered way under VR conditions with lower variance of head angle positions and lower number of errors compared to their performance by brochure instructions.

Conclusions:

Up to present, the principle of VR environment for self-administered performance of positioning manoeuvres is feasible and accurate. Further investigations are needed to address the question whether self-guided performance of repositioning manoeuvres yield a better outcome with respect to initial treatment by medical professional only and longer recurrence-free intervals.

Publication History

Publication Date:
23 April 2019 (online)