Evaluating the epley canalolith repositioning procedure with and without a visual assistive device

Hypothesis: The primary goal of this study was to examine how accuracy is affected when we employ a guidance device to assist with the execution of the Epley canalolith repositioning procedure. Background: Benign paroxysmal positional vertigo is a common cause of vestibular vertigo. Treatment is noninvasive and generally effective when performed correctly. Deficiencies in clinical application result in unnecessary failures in response for those affected. Methods: Ten participants were each taken through six iterations of the Epley canalolith repositioning procedure. Iterations were divided evenly between those conducted with and without the use of a guidance device. One clinician performed all 60 procedures. Head movements were recorded using motion capture cameras and strategically placed motion tracking markers. Results: Results showed that the guidance device significantly improved the latter phase maneuver accuracy. Rotation error was significantly reduced for hold3 with-device (M =20.238 , SD =12.088) versus without-device (M=40.138, SD=14.628, p=0.001). Maximal rotation error during rotation4 of the maneuver demonstrated a similar reduction of error with-device (M=24.448, SD=10.438) versus without-device (M=41.368, SD=12.898, p=0.002). Conclusion: A simple visual guidance device can increase the execution accuracy of canalith repositioning procedures. Further research is required to show how such improvements influence treatment efficacy.