Is the Gans Maneuver effective in reducing symptoms of vertigo in patients diagnosed with PC-BPPV?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is the Gans Maneuver effective in reducing symptoms of vertigo in patients diagnosed with PC-BPPV?” STUDY DESIGN: Review of three peer-review journal published, single-blinded randomized controlled trials all in the English language with human subjects on patients with PC-BPPV. DATA SOURCES: The three randomized controlled trials that were utilized for this review were found using PubMed, Cochrane Collaboration & Google Scholar. Articles were selected based on relevance to the proposed clinical question and the inclusion of outcomes with evidence that matters to these patients. OUTCOME(S) MEASURED: All of the articles selected measured the subjective absence of vertigo symptoms using some variation of a clinical tool after performing the Gans maneuver. RESULTS: Badawy et al. compared the Gans maneuver with post-therapeutic restrictions to a Canalith repositioning maneuver (modified Epley maneuver with post-therapeutic restrictions). Saberi et al. compared the Gans maneuver to the modified Epley maneuver. Muragod et al. compared the Gans maneuver to the Epley maneuver. All of the studies researched showed a statistically significant reduction in vertigo symptoms after receiving the Gans maneuver. Badawy et al. demonstrated that the reduction of vertigo symptoms over 1 month was an average of 9 out of 10 for the Gans maneuver with PTR when compared to the canalith repositioning maneuver (modified Epley with PTR) at 8 out of 10 change from baseline. Saberi et al. demonstrated that the average percentage of patients with subjective resolution of vertigo symptoms was 46.7% for the Gans maneuver and 70% for the modified Epley maneuver. Muragod et al. demonstrated that the average point change from baseline out of 100 on the DHI was 42.9 for the Gans maneuver and 44.9 for the Epley maneuver. CONCLUSIONS: The data presented by these three single-blinded RCTs suggests that the Gans maneuver is an effective alternative treatment for patients with PC-BPPV in reducing symptoms of vertigo. Future research is warranted with a larger sample size on the adverse side effects & relapse of symptoms for the Epley vs Gans maneuver