Automated Robotic Maneuvering System (RMS) vs Manual Reposition Maneuver in Treatment of Benign Paroxysmal Positional Vertigo (BPPV)

NCT ID: NCT05352555

Last Updated: 2022-04-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-15

Study Completion Date

2022-04-23

Brief Summary

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Comparison of treatment efficacy of an automated robotic maneuvering system (RMS) repositioning chair versus manual positioning maneuvers in Benign Paroxysmal Positional Vertigo.

Detailed Description

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The standard treatments for Benign Paroxysmal Positional Vertigo (BPPV) are manual positioning maneuvers. This method, beyond being costly and requiring extensive training, is a significant burden on healthcare resources. We developed an automated robotic maneuvering system, hereby known as RMS, to tackle this problem. Our Clinical Investigation is two-fold; (1) test the safety of RMS and, (2) understand the viability of RMS for treating BPPV when compared to manual positioning maneuvers.

Conditions

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Benign Paroxysmal Positional Vertigo

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients previously diagnosed with BPPV were referred to vestibular laboratory at the Department of Otolaryngology at Haseki Sultangazi Teaching and Research Hospital. Videonystagmography was performed on all subjects to confirm the BPPV diagnosis. Patients were then randomly divided into two groups; experimental and control. The experimental group was treated with RMS, while control group was treated with traditional manual canalith repositioning maneuvers on an examination table.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
Every enrolled patients records were randomized, and based on the outcome, subjects were either assigned to control or experimental arm groups. A report detailing the outcome, but omitting the method of treatment, was given to patients and their care provider.

Study Groups

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Robotic Maneuvering System (RMS)

BPPV subtype diagnosis and corresponding treatment will be performed using automated RMS chair and recorded with video frenzel goggle.

In cases of posterior canal involvement, Epley's maneuver will be used for canalithiasis and cupulolithiasis. Semont maneuver will be used as a second-line treatment for cupulolithiasis, in cases of initial failure.

In cases of horizontal canal involvement, Barbecue (Lempert) maneuver will be used. If canalithiasis or cupulolithiasis is diagnosed, Gufoni's maneuver will be performed.

In cases of anterior canal involvement, Yacovino's maneuver will be used.

Group Type EXPERIMENTAL

Automated vertigo repositioning chair

Intervention Type DEVICE

Patients are strapped to the chair with a safety harness, and video fenzel goggle are worn.

Automated diagnostic procedures are performed to determine vertigo subtype and orientation (Left/Right) (described below).

1. Dix-Hallpike (for posterior canal involvement)
2. Supine roll (for horizontal canal involvement)
3. (Optional) Deep Head Hanging (for anterior canal involvement)

If nystagmus is detected during automated diagnostic maneuvers, BPPV subtype is diagnosed, and corresponding automated treatment maneuver will be performed (described below).

1. Epley's and/or Semont's maneuver (for posterior canal involvement)
2. Barbecue and/or Gufoni's maneuver (for horizontal canal involvement)
3. Yacovino's maneuver (for anterior canal involvement)

10 minutes after performing automated treatment maneuver, provocative diagnostic test maneuver was performed once again to ensure successful intervention.

A follow-up was done one week later at the earliest.

Canalith Reposition Maneuver

BPPV subtype diagnosis and corresponding treatment will be performed with manual repositioning maneuvers and recorded with video frenzel goggle.

In cases of posterior canal involvement, Epley's maneuver will be used. In cases of horizontal canal involvement, Log roll maneuver will be used. In cases of anterior canal involvement, Yacovino's maneuver will be used.

Group Type ACTIVE_COMPARATOR

Canalith Reposition Maneuver

Intervention Type OTHER

Patients were seated on a examination table and given videonystagmography goggles (VNG).

Manual diagnostic procedures are performed to determine vertigo subtype and orientation.

The manual diagnostic procedures for Left and Right sided semicircular canals are:

1. Dix-Hallpike (for posterior canal involvement)
2. Supine roll and Bow and Lean (for horizontal canal involvement)

If nystagmus is detected during diagnostic maneuvers, BPPV subtype is diagnosed, and corresponding treatment maneuvers will be performed manually.

The automated treatment maneuvers are:

1. Epley's maneuver (for posterior canal involvement)
2. Barbecue and/or Gufoni's maneuver (for horizontal canal involvement)

Patients were called back for a follow up 2 days after performing manual treatment maneuvers. Provocative diagnostic testing maneuvers were performed again to ensure successful intervention.

A second follow-up was done one week later at the earliest.

Interventions

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Automated vertigo repositioning chair

Patients are strapped to the chair with a safety harness, and video fenzel goggle are worn.

Automated diagnostic procedures are performed to determine vertigo subtype and orientation (Left/Right) (described below).

1. Dix-Hallpike (for posterior canal involvement)
2. Supine roll (for horizontal canal involvement)
3. (Optional) Deep Head Hanging (for anterior canal involvement)

If nystagmus is detected during automated diagnostic maneuvers, BPPV subtype is diagnosed, and corresponding automated treatment maneuver will be performed (described below).

1. Epley's and/or Semont's maneuver (for posterior canal involvement)
2. Barbecue and/or Gufoni's maneuver (for horizontal canal involvement)
3. Yacovino's maneuver (for anterior canal involvement)

10 minutes after performing automated treatment maneuver, provocative diagnostic test maneuver was performed once again to ensure successful intervention.

A follow-up was done one week later at the earliest.

Intervention Type DEVICE

Canalith Reposition Maneuver

Patients were seated on a examination table and given videonystagmography goggles (VNG).

Manual diagnostic procedures are performed to determine vertigo subtype and orientation.

The manual diagnostic procedures for Left and Right sided semicircular canals are:

1. Dix-Hallpike (for posterior canal involvement)
2. Supine roll and Bow and Lean (for horizontal canal involvement)

If nystagmus is detected during diagnostic maneuvers, BPPV subtype is diagnosed, and corresponding treatment maneuvers will be performed manually.

The automated treatment maneuvers are:

1. Epley's maneuver (for posterior canal involvement)
2. Barbecue and/or Gufoni's maneuver (for horizontal canal involvement)

Patients were called back for a follow up 2 days after performing manual treatment maneuvers. Provocative diagnostic testing maneuvers were performed again to ensure successful intervention.

A second follow-up was done one week later at the earliest.

Intervention Type OTHER

Other Intervention Names

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Robotic Maneuvering System (RMS) Manual Reposition Maneuver

Eligibility Criteria

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Inclusion Criteria

* Characteristic positional nystagmus (for BPPV)
* Positive Dix-Hallpike
* Positive supine roll test
* Positive Deep Head Hanging
* Vertigo-Dizziness Imbalance symptom scores compatible with BPPV

Exclusion Criteria

* Pregnant patients
* Patients who have taken vertigo suppressing agents (Dimenhydrinate) in the last 48 hours
* Patients taller than 200 cm (2.0 m)
* Patients who have had a cardiovascular or neurosurgical operation in the last month
* Patients with retinal detachment and/or glaucoma
* Lack of treatment cooperation
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Haseki Sultangazi Teaching and Research Hospital, University of Health Sciences

UNKNOWN

Sponsor Role collaborator

Stratejik Yenilikci Girisimler Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Murat Haluk Ozkul

Chief Medical Officer (CMO)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Murat H Ozkul, M.D.

Role: PRINCIPAL_INVESTIGATOR

StatejikYG

Locations

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Haseki Sultangazi Training and Research Hospital

Istanbul, Sultangazi, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Tan J, Yu D, Feng Y, Song Q, You J, Shi H, Yin S. Comparative study of the efficacy of the canalith repositioning procedure versus the vertigo treatment and rehabilitation chair. Acta Otolaryngol. 2014 Jul;134(7):704-8. doi: 10.3109/00016489.2014.899711. Epub 2014 May 7.

Reference Type BACKGROUND
PMID: 24807849 (View on PubMed)

Choung YH, Shin YR, Kahng H, Park K, Choi SJ. 'Bow and lean test' to determine the affected ear of horizontal canal benign paroxysmal positional vertigo. Laryngoscope. 2006 Oct;116(10):1776-81. doi: 10.1097/01.mlg.0000231291.44818.be.

Reference Type BACKGROUND
PMID: 17003735 (View on PubMed)

West N, Hansen S, Moller MN, Bloch SL, Klokker M. Repositioning chairs in benign paroxysmal positional vertigo: implications and clinical outcome. Eur Arch Otorhinolaryngol. 2016 Mar;273(3):573-80. doi: 10.1007/s00405-015-3583-z. Epub 2015 Mar 7.

Reference Type BACKGROUND
PMID: 25749489 (View on PubMed)

Bhattacharyya N, Baugh RF, Orvidas L, Barrs D, Bronston LJ, Cass S, Chalian AA, Desmond AL, Earll JM, Fife TD, Fuller DC, Judge JO, Mann NR, Rosenfeld RM, Schuring LT, Steiner RW, Whitney SL, Haidari J; American Academy of Otolaryngology-Head and Neck Surgery Foundation. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2008 Nov;139(5 Suppl 4):S47-81. doi: 10.1016/j.otohns.2008.08.022.

Reference Type BACKGROUND
PMID: 18973840 (View on PubMed)

Pedersen MF, Eriksen HH, Kjaersgaard JB, Abrahamsen ER, Hougaard DD. Treatment of Benign Paroxysmal Positional Vertigo with the TRV Reposition Chair. J Int Adv Otol. 2020 Aug;16(2):176-182. doi: 10.5152/iao.2020.6320.

Reference Type BACKGROUND
PMID: 32784154 (View on PubMed)

Nakayama M, Epley JM. BPPV and variants: improved treatment results with automated, nystagmus-based repositioning. Otolaryngol Head Neck Surg. 2005 Jul;133(1):107-12. doi: 10.1016/j.otohns.2005.03.027.

Reference Type BACKGROUND
PMID: 16025062 (View on PubMed)

Richard-Vitton T, Seidermann L, Fraget P, Mouillet J, Astier P, Chays A. [Benign positional vertigo, an armchair for diagnosis and for treatment: description and significance]. Rev Laryngol Otol Rhinol (Bord). 2005;126(4):249-51. French.

Reference Type BACKGROUND
PMID: 16496552 (View on PubMed)

Yanik B, Kulcu DG, Kurtais Y, Boynukalin S, Kurtarah H, Gokmen D. The reliability and validity of the Vertigo Symptom Scale and the Vertigo Dizziness Imbalance Questionnaires in a Turkish patient population with benign paroxysmal positional vertigo. J Vestib Res. 2008;18(2-3):159-70.

Reference Type BACKGROUND
PMID: 19126986 (View on PubMed)

Other Identifiers

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SYG-RMS-18

Identifier Type: -

Identifier Source: org_study_id

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