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Knowledge transfer and education
Effectiveness of the particle repositioning maneuver for benign positional vertigo following traumatic brain injury
  1. Donna Ouchterlony1,
  2. Alicja Michalak1,
  3. Jane Topolovec-Vranic1,
  4. John A Rutka1,2,
  5. Cheryl Masanic1,3
  1. 1Head Injury Clinic, St. Michael's Hospital
  2. 2Toronto General Hospital
  3. 3Toronto Rehabilitation Institute, Toronto, ON, Canada


Objective The purpose of this pilot project was to explore the clinical presentation of benign positional vertigo (BPV) in patients with mild or moderate traumatic brain injury (TBI) and to determine if a non-invasive bedside intervention, the Particle Repositioning Maneuver (PRM) would be effective in treating BPV.

Design Observational, cohort prospective study, with repeated measures of three groups of patients diagnosed with TBI.

Setting Subjects were recruited from an out-patient clinic specialising in the management of TBI in a large, urban, academic hospital.

Participants 56 subjects with mild to moderate TBI: 21 patients with BPV, 23 with non-specific dizziness, and 12 without any form of dizziness.

Intervention Patients were assessed at baseline and at 1, 5, 9 weeks and 3 months post-enrollment. BPV was confirmed by the administration of the Dix-Hall Pike Maneuver to patients with dizziness at each assessment and those positive for BPV received PRM treatment.

Outcome Measures Demographic and injury-related data were collected and the Dizziness Handicap Inventory (DHI) and Short-Form Health Survey (SF-36) were administered at each assessment. Mean difference in DHI scores between baseline and follow-ups were assessed.

Results DHI scores were significantly reduced in the BPV group (20.6; p<0.01) and dizziness symptoms had resolved in 52% of patients. A significant improvement on the SF-36 physical component scores was found for the BPV group (increasing from 38.1 at baseline to 45.7 at 3 months; p<0.01)

Conclusions Our pilot study demonstrated both significantly improved dizziness symptoms and physical wellbeing for BPV patients who received PRM treatment.

Competing interests None.

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