Surveying physical therapists' understanding of benign paroxysmal positional vertigo.
Regan G Harrell, Rebecca Hart, Joanna C Jen and 1 others
PMID 37662546WHAT IT FOUND
Most therapists would always test for classic BPPV, but fewer than half recognized subjective BPPV.
Experience and practice setting did not improve diagnostic accuracy. Low recognition of subtle variants suggests therapists may miss treatable cases when nystagmus is absent.
Key findings
01Only 51% of respondents correctly identified subjective BPPV in a vignette where the patient reported dizziness without nystagmus.
0285% of respondents correctly identified BPPV with vestibular agnosia, a variant defined by nystagmus without reported vertigo.
03Years of clinical experience did not significantly correlate with the ability to correctly diagnose BPPV variants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample consisted of attendees at continuing education conferences, which likely selects for therapists already interested in vestibular care, potentially overestimating general knowledge. The survey used hypothetical vignettes rather than observing actual clinical decision-making with real patients. Respondents self-reported their practice settings and experience, which may introduce recall or social desirability bias. The study did not assess whether therapists knew the appropriate treatment protocols for the variants they failed to diagnose.
Declared interests
The authors declared no conflicts of interest. The study was approved by the University of Pittsburgh Biomedical IRB.
The easy way to misread this
Do not assume that experienced therapists or those in specialized vestibular clinics are better at recognizing subtle BPPV variants. The study found no significant correlation between experience or practice setting and diagnostic accuracy, meaning knowledge gaps likely exist across the profession regardless of tenure.