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Instrument Reviewers

Initially reviewed by Jason Raad, MS in 4/2012.Reviewed and Updated by Karen Lambert PT, MPT, NCS and Linda B. Horn PT, DScPT, MHS, NCS of the VEDGE task force for the Neurology section of the APTA in 2013

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association¡¯s Multiple Sclerosis Taskforce (MSEDGE), Parkinson¡¯s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  

Recommendations for use based on acuity level of the patient:

Recommendations based on vestibular diagnosis

Recommendations for entry-level physical therapy education and use in research:

Considerations

• Due to the frequency of BPPV that has been detected in individuals who had not previously reported symptoms, the VEDGE task force recommends performing positional testing to rule out positional vertigo when assessing any patient that complaints of dizziness and balance impairments
• Some training is recommended (through coursework or article review) to assist with technique and interpretation (as improper positioning could result in a false negative test)
• If a patient is unable to attain proper positioning for the Dix-Halpike test, an alternative test (such as the sidelying test) should be performed
• 11% of patients may have false-negative results when first assessed (Burston et al, 2012)
• Up to 25% of patients with BPPV may not demonstrate nystagmus during the ¶Ù¾±³æ¨C±á²¹±ô±ô±è¾±°ì±ð test (Noda et al, 2011)

Do you see an error or have a suggestion for this instrument summary? Please e-mail us! 

Bibliography

Burston, A., Mossman, S., et al. (2012). "Are there diurnal variations in the results of the Dix-Hallpike manoeuvre?" J Clin Neurosci 19(3): 415-417. 

Cohen, H. S. (2004). "Side-lying as an alternative to the Dix-Hallpike test of the posterior canal." Otol Neurotol 25(2): 130-134. 

Dix, M. and Hallpike, C. (1952). "The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system." Proceedings of the Royal Society of Medicine 45(6): 341. 

Gordon, C. R., Levite, R., et al. (2004). "Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form?" Arch Neurol 61(10): 1590. 

Halker, R. B., Barrs, D. M., et al. (2008). "Establishing a diagnosis of benign paroxysmal positional vertigo through the dix-hallpike and side-lying maneuvers: a critically appraised topic." Neurologist 14(3): 201-204. 

Kerrigan, M. A., Costigan, M. F., et al. (2013). "Prevalence of benign paroxysmal positional vertigo in the young adult population." PM R 5(9): 778-785. 

Noda, K., Ikusaka, M., et al. (2011). "Predictors for benign paroxysmal positional vertigo with positive Dix-Hallpike test." Int J Gen Med 4: 809-814. 

Oghalai, J. S., Manolidis, S., et al. (2000). "Unrecognized benign paroxysmal positional vertigo in elderly patients." Otolaryngology - Head and Neck Surgery 122(5): 630-634. 

Pollak, L., Davies, R. A., et al. (2002). "Effectiveness of the particle repositioning maneuver in benign paroxysmal positional vertigo with and without additional vestibular pathology." Otology & neurotology 23(1): 79.