Stroke
Conditions
Brief summary
This randomized controlled trial aims to compare the effectiveness of the Epley maneuver and the Semont maneuver in reducing dizziness and improving balance in stroke survivors diagnosed with posterior canal benign paroxysmal positional vertigo (BPPV). Forty participants will be randomly allocated to either intervention or comparator group. Outcomes will be assessed using the Dizziness Handicap Inventory (DHI), Berg Balance Scale (BBS), and Dix-Hallpike test at baseline, 2 weeks, and 4 weeks.
Detailed description
Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder and frequently affects the posterior semicircular canal. Stroke survivors with BPPV often experience dizziness, impaired balance, and an increased risk of falls. The Epley and Semont maneuvers are evidence-based repositioning techniques used to treat posterior canal BPPV. However, evidence comparing these two maneuvers specifically in stroke survivors is limited. This randomized controlled trial will compare their effectiveness in reducing dizziness and improving balance over a 4-week intervention period with follow-up assessments. The findings may help guide physiotherapists in selecting the most effective treatment for this population.
Interventions
OTHEREpley Maneuver
Epley Maneuver: Participants will be randomly allocated to either the Epley maneuver group or the Semont maneuver group. The affected side will be identified using the Dix-Hallpike test before treatment. Participants in the Epley group will receive the canalith repositioning maneuver involving sequential head and body movements to facilitate the movement of displaced otoconia from the posterior semicircular canal into the utricle.
OTHERSemont Maneuver
Participants in the Semont group will receive the liberatory maneuver involving rapid sequential movements between side-lying positions while maintaining the prescribed head rotation.
Sponsors
Ibadat International University, Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age: above 18years Diagnosed with stroke survivors Diagnosed with posterior canal BPPV via Dix-Hallpike Test Functional status: Able to sit or walk with/without support, follow instructions, and participate in treatment sessions Willing to participate
Exclusion criteria
* Other vestibular disorders (e.g., Meniere's disease (inner ear disorder causing vertigo, hearing loss, and tinnitus)) Diagnosed cognitive impairment (unable to follow instructions) Medically unstable patients Severe cervical spine disorders (e.g., instability, fracture) Spinal conditions restricting head movement Completely bed-bound patients Any contraindication to Dix Hallpike repositioning maneuvers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dizziness Handicap Inventory | Baseline, 2 weeks, and 4 weeks | To assess the severity and impact of dizziness and balance in physical aspects of daily life. The questionnaire consists of 25 items scored as 0 (no), 2 (sometimes), and 4 (yes), yielding a total score ranging from 0 to 100. Higher scores indicate greater dizziness-related handicap. Total scores will be interpreted as mild (0-30), moderate (31-60), or severe (61-100) handicap |
| Berg Balance Scale | Baseline, 2 weeks, and 4 weeks | The scale consists of 14 tasks, each scored from 0 to 4, yielding a total score ranging from 0 to 56. Higher scores indicate better balance performance, whereas lower scores indicate greater balance impairment |
Countries
Pakistan
Contacts
CONTACTDr. Somiya Naz, BSPT, PPDPT, PHD Scholar
CONTACTHira Asif, DPT, MSPT*
PRINCIPAL_INVESTIGATORSomiya Naz, BSPT, PPDPT, PHD Scholar
IBADAT INTERNATIONAL UNIVERSITY
Outcome results
None listed