- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04578262
Epley Manoeuvre in Participants With Multiple Sclerosis Diagnosed From Benign Paroxysmal Positional Vertigo
October 6, 2020 updated by: Cristina García Muñoz, University of Seville
Epley Manoeuvre for Posterior Semi-circular Canal Benign Paroxysmal Positional Vertigo in People With Multiple Sclerosis: Protocol of a Randomized Controlled Trial
Vertigo, dizziness and control postural disturbance are one of the most disabling symptoms in Multiple Sclerosis.
These could be caused by a peripheral or central vestibular disorder.
Although, central vestibular damage is more prevalent, peripheral vestibular disturbance aetiology is significantly common in this disease.
Within peripheral vestibulopathy, benign paroxysmal positional vertigo is the most common syndrome.
Impairments of posterior semi-circular canals in benign paroxysmal positional vertigo represent among the 60-90 % of the cases.
Gold standard treatment in this syndrome is the canalith repositioning procedure, called Epley manoeuvre.
This manoeuvre has been deeply investigated in previous studies for participants who only suffer from benign paroxysmal positional vertigo.
Any randomized clinical trials have been carried out to assess the effectiveness of Epley manoeuvre.
However, a retrospective research and a case study reported encouraging results for the resolution of posterior semi-circular canal benign paroxysmal positional vertigo, through the Epley manoeuvre.
The main objective of the study is to assess the effectiveness of the Epley Manoeuvre for the improvement of the benign paroxysmal positional vertigo of participants with multiple sclerosis, compared to a passive control group.
Study Overview
Status
Unknown
Intervention / Treatment
Detailed Description
After given oral and written information to participants, they will be freedom to decide their wish to participate.
After the invitation, those participants who desire to be part of study will sign the written informed consent.The study describes a two-arms, parallel groups design and double-blind randomized clinical trial.
A prospective study with randomized and conceal allocation will be performed to prevent possible bias.
Participants and evaluators will be blinded to group allocation.
The randomized controlled trial have 3 evaluations of the sample, that will be carried out at baseline, immediately after intervention and 48 hours later
Study Type
Interventional
Enrollment (Anticipated)
80
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Cristina García-Muñoz
- Phone Number: +34689371303
- Email: ccriss.g@gmail.com
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Adults of both genders aged from 18 to 65 years old.
- clinically diagnosed of any MS subtype (relapsing-remitting, primary progressive and secondary progressive),
- with an Expanded Disability Status Scale (EDSS) ranging from 1 to 5 points,
- diagnosed of posterior semi-circular canals benign paroxysmal positional vertigo by an otolaryngologist and a physical therapist expert in vestibular rehabilitation.
Exclusion Criteria:
- Changes in MS pharmacotherapy within the last 3 months,
- BPPV treatments as vestibular sedatives, corticosteroids, morphic and antihistamines, at least 72 hours before intervention,
- alcohol consumption in the last 72 hours,
- severe visual impairments,
- participants who have received vestibular rehabilitation within the last 3 months,
- existence of any other neurologic disease.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Epley Manoeuvre
Epley manoeuvre in participants with Multiple Sclerosis who suffer from benign paroxysmal positional vertigo.
Only one administration.
|
This manoeuvre is constituted by five steps.
In the first step, while the patient is in supine posture the head will be positioned 45 degrees turned towards the unaffected ear and the head slightly overhang on the edge of the couch.
In this second step maintaining the previous position of the head, physiotherapist will turn head 45 degrees turned towards the affected ear.
Next, in the third step, the whole body will turn until is located 135 degrees from the baseline supine position.
In the fourth step, while the head keeps turned to the affected ear the subject will be incorporated until he is sitting.
In the fifth step, while the subject is seated with the head in neutral position the chin will be bended 20 degrees.
Each procedure will be held among 30 seconds or two minutes, while the dizziness or the nystagmus vanish.
The intervention will be conducted at the Physical Therapy Department of the University of Sevilla (Spain).
Other Names:
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Sham Comparator: Sham Manoeuvre
The second group will received a sham manoeuvre.
However after the experimental intervention ends, this groups will also receive Epley manoeuvre.
|
The sham manoeuvre consist is going to star with the participant in a neutral seated position.
Sum to it, head is rotated 45 degrees towards the unaffected vestibule.
After that, the participant will be guided by the physiotherapist to a lateral decubitus position towards the affected side on which his nose will be pointing above.
To conclude, the seated position will be reached again without head rotation.
Each position of the sham manoeuvre will be maintained along one minute.
During all the process the videonystagmography glasses will be dressed by participants and they will be indicated not to close eyes in the intervention.
After the execution of the manoeuvre, also this group will be evaluated 48 hours after.
The intervention will be conducted at the Physical Therapy Department of the University of Sevilla (Spain).
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in the conversion of a positive to a negative Dix Hallpike Test
Time Frame: Baseline, immediately after intervention and 48 hours after intervention.
|
The performance of Dix Hallpike Test consists on a participant sit on a table and the head is turn 45 degrees towards the tested side.
Once this position is stablished, the evaluator is going to laid back the participant in a quick movement sum to a neck extension of 20 degrees with the affected ear down.
Throughout the process subject will be indicated to keep eyes open to allow the search of nystagmus.
If torsional nystagmus or vertigo appears while the head is down it is indicative of posterior canal benign paroxysmal positional vertigo.
|
Baseline, immediately after intervention and 48 hours after intervention.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Impact of dizziness in the quality of life in participants with Multiple Sclerosis. Dizziness Handicap Inventory (DHI).
Time Frame: Baseline, immediately after intervention and 48 hours after intervention.
|
Dizziness Handicap Inventory is a self-assessment questionnaire of 25- items and the total score is 100.
The score is calculated by summing ordinal scales responses, higher scores means higher level of disability and handicap constituted by the physical, emotional and functional subscale.
Physical and emotional subscales range from 0 to 36 points, and functional from 0 to 28.
|
Baseline, immediately after intervention and 48 hours after intervention.
|
Independency in activities of daily living measure by Vestibular Disorders Activities of Daily Living Scale (VADL).
Time Frame: Baseline, immediately after intervention and 48 hours after intervention.
|
Vestibular Disorders Activities of Daily Living Scale (VADL) is a self-reported questionnaire that measures the independence on activities of daily living in people with vestibular disorders.
This scale is composed by 28 items divided in three subcategories: 12 questions of functional skills, 9 questions of ambulation skills and 7 questions of instrumental skills.
Each item is rate un a 10-point scale, in which higher score means less independence in ADL.
The total score is the median of each subscale.
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Baseline, immediately after intervention and 48 hours after intervention.
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Maria Jesus Casuso-Holgado, University of Seville
- Principal Investigator: Cristina García-Muñoz, University of Seville
- Principal Investigator: Marilo Dolores Cortes-Vega, University of Seville
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
November 1, 2020
Primary Completion (Anticipated)
February 1, 2022
Study Completion (Anticipated)
March 1, 2022
Study Registration Dates
First Submitted
September 20, 2020
First Submitted That Met QC Criteria
October 6, 2020
First Posted (Actual)
October 8, 2020
Study Record Updates
Last Update Posted (Actual)
October 8, 2020
Last Update Submitted That Met QC Criteria
October 6, 2020
Last Verified
October 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Immune System Diseases
- Demyelinating Autoimmune Diseases, CNS
- Autoimmune Diseases of the Nervous System
- Demyelinating Diseases
- Autoimmune Diseases
- Neurologic Manifestations
- Otorhinolaryngologic Diseases
- Labyrinth Diseases
- Ear Diseases
- Vestibular Diseases
- Sensation Disorders
- Multiple Sclerosis
- Sclerosis
- Vertigo
- Benign Paroxysmal Positional Vertigo
- Dizziness
Other Study ID Numbers
- University of Seville Protocol
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Yes
IPD Sharing Supporting Information Type
- Study Protocol
- Clinical Study Report (CSR)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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