Benign positional vertigo, or BPV, affects 2 to 3 percent of the population over the course of their lifetime, according to a study published in the July 2007 issue of the "Journal of Neurology, Neurosurgery and Psychiatry." BPV is characterized by recurrent episodes of a form of dizziness known as vertigo, which involves an intense spinning sensation. The episodes are usually triggered by rapid head movements. Although uncomfortable and disruptive, this condition is not serious and usually improves with specialized exercises.
There are several effective exercises for BPV. Each involves a controlled sequence of movements to rebalance the fluids and particles in the inner ear. The Epley maneuver is one BPV exercise recommended by the American Academy of Otolaryngology -- Head and Neck Surgery. It begins in a sitting position with the head rotated 45 degrees to the side. While maintaining her head position, the person lies on her back. The head is then rotated 90 degrees to the opposite side. The person then shifts to a side-lying position so her body aligns with her head. The sequence ends with the individual returning to a sitting position. Each position is held for roughly 30 to 60 seconds. Depending on whether symptoms persist, the exercise may be repeated 3 to 5 times per session several times weekly.
The Semont maneuver is also recommended by the American Academy of Otolaryngology -- Head and Neck Surgery for BPV. The sequence begins in the sitting position. The person turns his head 45 degrees to the side and quickly shifts to a side-lying position with his head position maintained. After roughly 30 seconds, he quickly sits up and immediately shifts to lying on his other side, without pausing in the sitting position. He maintains his head in the same position during this shift. After about 30 seconds, the sequence concludes with the individual gradually returning to a sitting position. When using the Semont maneuver, it is essential to establish which side is causing the BPV symptoms, because the head should be turned toward the opposite side throughout the exercise.
The Brandt-Darroff exercise is an option for BPV. The exercise begins in a sitting position. The person turns her head to the side, tilting her chin toward her shoulder before quickly lying on her side with her head turned upward. After about 30 seconds, she returns to the sitting position and repeats the process on the other side, turning her head in the opposite direction. The whole sequence is typically repeated 5 times per session several times per week.
Effectiveness of Exercises for BPV
A research study published in the June 2008 issue of the "Journal of Otolaryngology and Head and Neck Surgery" reported that people with BPV show long-term improvement with exercise-based treatment. BPV typically resolves on its own even without treatment. But because of the often dramatic discomfort caused by the bouts of dizziness, it can be beneficial to use exercises to speed improvement.
BPV Exercises With Physical Limitations
A study published in the May 2013 issue of the "Journal of Neurology" describes an effective alternative exercise for people who have trouble sitting up or easily moving between lying and sitting positions. The exercise consists of alternating between lying on the back facing up, then lying on one side looking directly forward. The person then shifts back to lying face up before turning her body and lying on the opposite side looking directly forward.
- Journal of Neurology, Neurosurgery, and Psychiatry: Epidemiology of Benign Paroxysmal Positional Vertigo -- A Population Based Study
- Office Practice of Neurology: Martin Samuels
- Journal of Otolaryngology -- Head and Neck Surgery: Efficacy of a Home-Based Exercise Program on Benign Paroxysmal Positional Vertigo Compared With Betahistine
- Otolaryngology -- Head and Neck Surgery: Clinical Practice Guideline -- Benign Paroxysmal Positional Vertigo
- Journal of Neurology: Supine to Prolonged Lateral Position -- A Novel Therapeutic Maneuver for Posterior Canal Benign Paroxysmal Positional Vertigo