{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T20:00:46Z","timestamp":1792872046794,"version":"4.5.0"},"reference-count":54,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Vestibular Research"],"published-print":{"date-parts":[[2020,4,8]]},"abstract":"<jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>QUESTION:<\/jats:title>\n                    <jats:p>Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of dizziness presenting to specialist vestibular centres and accounts for approximately 20\u201330% of referrals to these clinics. In spite of the amount of clinical knowledge surrounding its diagnosis and management, the treatment of BPPV remains challenging for even the most experienced clinicians. This study outlines the incidence of BPPV in a specialised vestibular physiotherapy clinics and discusses the various nuances encountered during assessment and treatment of BPPV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>DESIGN:<\/jats:title>\n                    <jats:p>Observational Study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>PARTICIPANTS:<\/jats:title>\n                    <jats:p>314 patients with various forms of Benign Paroxysmal Positional Vertigo (BPPV)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>INTERVENTION:<\/jats:title>\n                    <jats:p>Canalith repositioning manoeuvres (CRP) for posterior canal (PC) or horizontal canal (HC) BPPV depending on the canal and variant of BPPV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>OUTCOME MEASURES:<\/jats:title>\n                    <jats:p>Negative Dix-Hallpike (DHP) or Supine roll test (SRT) examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>In 91% of cases, PC BPPV was effectively treated in 2 manoeuvres or less. Similarly, 88% of HC BPPV presentations were effectively managed with 2 treatments. Bilateral PC, multiple canal or canal conversions required a greater number of treatments. There was no noticeable difference in treatment outcomes for patients who had nystagmus and symptoms during the Epley manoeuvre (EM) versus those who did not have nystagmus and symptoms throughout the EM. Nineteen percent of patients experienced post treatment down-beating nystagmus (DBN) and vertigo or \u201cotolithic crisis\u201d after the first or even the second consecutive EM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Based on the data collected, we make several clinical recommendations for assessment and treatment of BPPV. Firstly, repeated testing and treatment of BPPV within the same session is promoted as a safe and effective approach to the management of BPPV with a low risk of canal conversion. Secondly, vertigo and nystagmus throughout the EM is not indicative of treatment success. Thirdly, clinicians must remain vigilant and mindful of the possibility of post treatment otolithic crisis following the treatment of BPPV. This is to ensure patient safety and to prevent possible injurious falls. Our results challenge several clinical assumptions about the assessment and treatment of BPPV including the utility of certain markers of treatment success; hence influencing the current clinical guidelines and clinical practice and paving the way for future studies of the assessment and management of patients with BPPV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/ves-190687","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T13:19:50Z","timestamp":1576243190000},"page":"55-62","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":72,"title":["Characteristics of assessment and treatment in Benign Paroxysmal Positional Vertigo (BPPV)"],"prefix":"10.1177","volume":"30","author":[{"given":"Laura","family":"Power","sequence":"first","affiliation":[{"name":"Royal Victorian Eye and Ear Hospital","place":["Australia"]},{"name":"Dizzy Day Clinics","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Murray","sequence":"additional","affiliation":[{"name":"Dizzy Day Clinics","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Szmulewicz","sequence":"additional","affiliation":[{"name":"Royal Victorian Eye and Ear Hospital","place":["Australia"]},{"name":"Monash University","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,12,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200101000-00013"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.7.1297"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2013.00136"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500804"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816689667"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.199208"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.07.045"},{"issue":"6","key":"e_1_3_2_9_2","first-page":"301","article-title":"Downbeating nystagmus in Benign Paroxysmal Positional Vertigo: An apogeotrophic variant of posterior semicircular canal","volume":"1","author":"Carmona S.","year":"2017","unstructured":"CarmonaS., ZalazarG., WeisnchelbaumR., GrinsteinG., BreinbauerH. and LibonatiG.A., Downbeating nystagmus in Benign Paroxysmal Positional Vertigo: An apogeotrophic variant of posterior semicircular canal, Current Opinion in Neurological Science 1(6) (2017), 301\u2013305.","journal-title":"Current Opinion in Neurological Science"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200201000-00030"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.2310\/7070.2001.19532"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2016.12.050"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/003591575204500604"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/019459989210700310"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e31823e274a"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)60518-7"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.10.1590"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20130239"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1996.01890150059011"},{"key":"e_1_3_2_20_2","volume-title":"Vestibular Rehabilitation","author":"Herdman S.J.","year":"2014","unstructured":"HerdmanS.J., ClendanielR.A., Vestibular Rehabilitation. 4 ed. 2014, Philidelphia: F.A. 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