To compare the treatment efficacy of the Epley maneuver and the 360° maneuver in a cohort diagnosed with posterior benign paroxysmal positional vertigo (BPPV) using a mechanical rotation chair (MRC).
✦ The floor
Discussion
Signed responses from readers of the wire.
Results of this RCT may refine which repositioning maneuver to prefer for posterior canal BPPV when a mechanical rotation chair is available, but await full reading of outcome data before changing standard Epley-first practice.
Head-repositioning maneuvers are the frontline treatment for the most common form of BPPV, and determining whether motorized-chair-assisted alternatives outperform the Epley maneuver could meaningfully improve first-visit resolution rates.
- 01RCT directly comparing Epley vs. 360° maneuver for posterior canal BPPV.
- 02Both maneuvers delivered via a mechanical rotation chair for standardized positioning.
- 03Study design reduces clinician variability, a common confounder in BPPV maneuver research.
- 04Published in Frontiers in Neurology (DOI: 10.3389/fneur.2026.1909757).
- 05Findings could inform protocol selection when motorized repositioning chairs are available.
The 360° maneuver can be used as an alternative to the Epley maneuver for posterior canal BPPV treatment.
studypartially supportedA mechanical rotation chair standardizes maneuver delivery and reduces clinician-dependent variability.
studysupported- PMID
- 42781309
- DOI
- 10.3389/fneur.2026.1909757.
- Journal
- Frontiers in Neurology
- Publication type
- research_article
- Evidence level
- 1b
- Population
- Patients with posterior canal benign paroxysmal positional vertigo (BPPV)
- Intervention
- 360° maneuver delivered via mechanical rotation chair
- Comparator
- Epley maneuver delivered via mechanical rotation chair
Primary outcomes
Resolution of posterior canal BPPV (negative Dix-Hallpike test); Treatment success rate