Effectiveness of forced prolonged position for geotropic horizontal canal BPPV: a systematic review

AbstractBackground Geotropic horizontal canal BPPV may be effectively treated using roll maneuvers or side-lying maneuvers. Forced prolonged position (FPP), initially described in 1997, may be used alone or in conjunction with these roll maneuvers or side-lying maneuvers in the treatment of geotropic horizontal canal BPPV.Objectives The purpose of this systematic review was to determine the effectiveness of FPP for the treatment of geotropic horizontal canal BPPV.Methods A literature search was conducted using CINAHL Complete, ProQuest Medical Database, PubMed, Web of Science, and Wiley Online Library as the databases. The search terms applied were geotropic AND (horizontal OR lateral) AND vertigo AND (‘forced prolonged position’ OR ‘forced prolonged positioning’).Results The efficacy of FPP ranged between 73.0% and 100.0% for the resolution of the vertigo and/or nystagmus associated with geotropic horizontal canal BPPV. FPP appears to be a more suitable intervention than roll maneuvers for individuals with physical impairments such as age-related limitations, obesity, neck pain, back pain, and/or other musculoskeletal disorders. Although the Gufoni maneuver, the most common side-lying maneuver, requires much less time to perform than FPP and may be more appropriate for those individuals who are unable to maintain a side-lying position for a prolonged period, the quick movements required for the performance of this intervention can elicit severe neurovegetative symptoms.Conclusions Therapists should consider using FPP with individuals who have been diagnosed with geotropic horizontal canal BPPV. FPP might be effective if used independently or in combination with another intervention, such as the Gufoni maneuver.Keywords: Benign paroxysmal positional vertigoBPPVforced prolonged positiongeotropichorizontal canal Disclosure statementNo potential conflict of interest was reported by the authors.Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.