What is Epley Maneuver?

It is a type of exercise that aims at moving the Otoconia located in the inner ear and relocating them in a different section of the ear. This technique of workout is also known by other names like Canalith Repositioning Maneuver and Particle Repositioning.

Epley Maneuver Exercises

This training exercise involves positioning the head of the patients into four successive movements, assigning a stipulated duration of time to each posture. Here is a stepwise guide on how to perform this exercise:

• Sit in an upright posture. Turn your head to the affected direction at a 45 degree angle. Hold this position and slowly lie down on your back.
• Remain in this posture for at least 4-5 minutes. Next, tilt your head at a 90 degree angle to the other direction.
• Hold this posture for 5 minutes more. Tilt your body onto the other side with your face aiming downwards.
• After you have remained for 5 minutes in this posture, retreat to your upright, sitting posture. Stay in that posture for approximately 30 seconds.
• Perform these steps again for at least 2 to 3 times.  Relax.

Epley Maneuver and Benign Positional Vertigo

This exercise is frequently used to cure Benign Paroxysmal Positional Vertigo (BPPV). The technique involves moving the affected person through a series of postures that are designed to remove the debris stuck in the ear which result in vertigo. This exercise is quite effective in providing relief in approximately 70% of cases. Patients usually do not require any follow up treatment after performing this technique. However, additional positional therapy or more aggressive remedial measure such as surgery may be needed in some cases.

How to do the Epley Maneuver?

This technique is strongly recommended by doctors to be carried out in the office of a therapist or doctor. This is done because Vertigo can arise due to a number of health problems. Doctors can ensure whether Epley Maneuver is more suited for curing the patient than other measures before carrying it out. It is also necessary to identify the ear at the back of the vertigo for making the process work well. A doctor should ideally be present while the patient undergoes Epley Maneuver. In case any complications develop, a doctor may be able to address it immediately.

Epley Maneuver Side Effects

A patient often suffers from symptoms like dizziness and vertigo while performing this technique. This necessitates the presence of a doctor. A doctor can provide patients with stability during the exercise. After the process has been performed, the patient may be unable to walk for a few minutes at a stretch due to extreme dizziness. This makes it necessary for a family member or a friend to accompany the patient to and from the doctor’s office.

In the subsequent days after performing the exercises, the patient needs to hold his or her head vertical. The sufferer should sleep in a semi-prone posture. A patient can start normal activities after about a week.

Epley Maneuver Instructions

If patients suffer from Vertigo, they can use Brandt-Daroff Exercises to manage it. Doctors can show this exercise to their patients and provide advice on how to perform them safely. However, home exercises should not be performed by patients unless they are sure about the underlying condition. This technique only helps resolve Calcium Carbonate Crystal accumulation in the ear and performing it can lead to complications if tumors and not vertigo is found to be the causative condition.

Here is a step by step guide on how to perform Brandt-Daroff Exercises.

• Sit in an upright posture on your bed.
• Lie down onto one side and get into that position in as comfortable a manner as possible.
• Tilt your head to a 45 degree angle. Try imagining a person of about six feet height standing in front of you and try to keep looking at the head of that person at all times.
• Remain lying on your side for approximately thirty seconds or until the dizziness has lessened.
• Go back to an upright posture. Take rest for half a minute.
• Next, lie down onto the other side. You should ideally take approximately one to two seconds to get into that posture.
• Keep your head tilted at an angle of 45 degrees.
• Stay down in that position for another half minute or until your dizziness has reduced.
• Go back to an upright posture. You have completed one repetition of this exercise. Wait for about a minute before performing another repetition.

Five repetitions of this exercise constitute one set. You should try to perform one set of this exercise for three times every day. It should preferably be carried out once in the morning, once at mid-day and again in the evening. The exercises should be performed for at ten to fourteen days. Most sufferers get complete relief from their symptoms approximately after ten days. Benign Paroxysmal Positional Vertigo (BPPV) tends to come back in approximately 30 % patients within a year. If there is a recurrence of Vertigo, patients may add a 10-minute exercise everyday to their daily routine.

Modified Epley Maneuver

Modified Epley Maneuver is the most effective technique for curing acute cases of Benign Positional Vertigo. It is a safe, simple process that may be performed within a short time by the bedside of an affected person. The head of the patient is moved around in such a way that Otoliths (debris of Calcium Carbonate) retreat to their original position. Acute Benign Positional Vertigo is caused when these specks get accidentally displaced into the semicircular canal from the utricle. In most patients, otoliths that are displaced eventually dissolve without any additional cure. However, Modified Epley Maneuver can immediately bring about an improvement or even treat the symptoms of the patient as soon as it is completed. The technique helps the calcium crystals slip into a region of the inner ear from the semicircular canal where they will not result in any more symptoms.

Modified Epley Maneuvers are often accompanied by another technique known as the Semont Maneuver. Both these exercises are used to cure Benign Paroxysmal Positional Vertigo (BPPV). The two workouts are performed with the help of a physical therapist or a health professional. The exercises can be cured in a single session that usually lasts from 10 to 15 minutes.

Epley Maneuver Diagram

Here are some Epley Maneuver pictures that will give you an idea how this process is performed. You may find these Epley Maneuver images very useful for reference.

References:

http://www.medscape.com/viewarticle/718348

http://www.dizziness-and-balance.com/disorders/bppv/brandt/ninth.html

http://www.umm.edu/otolaryngology/bppv.htm#brandt

https://www.ecorsolutions.com/hw/kbase/topic/detail/other/hw205519/detail.htm