human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To establish a possible causal factor for residual dizziness ( RD ) after successful repositioning maneuvers in patients with benign paroxysmal positional vertigo ( BPPV ) . Material s and Method : Ninety consecutive patients with idiopathic BPPV were treated with repositioning maneuvers , and the rate of RD was assessed as well as clinical data .  Posturography and assessment of anxiety levels were performed on patients reporting RD . Results were compared with a control group of BPPV patients of the sample after repositioning maneuvers and without RD . Results : Twenty-eight subjects ( 31.1 % ) reported RD on the second day after successful repositioning maneuvers . The mean duration of RD was 11.6 ± 3.9 days . Patients with RD presented a higher duration of BPPV ( 14.1 vs. 10.9 days , p = 0.01 ) . A correlation was demonstrated between the duration of BPPV and duration of RD ( p < 0.01 ) . Subjects with RD presented increased body sways , above all in eyes-closed conditions . Conclusion : RD is mainly correlated with duration of vertigo in BPPV patients . Anxiety was demonstrated to play a role in increased body sways Background : Canalith repositioning procedure ( CRP ) has increasingly been utilized for the last 15 years for the treatment of benign paroxysmal positional vertigo ( BPPV ) . We assess the short- and long-term efficacy of CRP on the treatment of patients with BPPV . Methods : Nine hundred sixty-five patients ( 481 men and 484 women , from 18 to 87 years of age ) were enrolled in this prospect i ve study during 1995–2010 . Inclusion criteria were a patient history compatible with BPPV and a positive provocative maneuver ( either Dix-Hallpike or Roll test ) . Reported duration of symptoms at the time of their first examination varied from 1 day to 18 months . Variants of the Epley and Barbeque maneuver were used for posterior and anterior canal involvement , and horizontal canal involvement , respectively . Short-term follow-up was obtained 48 h and 7 days after initial treatment , whereas long-term follow-up was obtained at repeated 6-month intervals . Results : Symptoms subsided immediately in 819 patients ( 85 % ) by the first CRP . Only 19 patients ( 2 % ) required CRP more than 3 times . Patients ’ mean follow-up was 74 months ; symptom recurrence was noted in 139 patients . A statistically significantly higher recurrence rate was noted in elderly people or those with head trauma or a history of vestibular neuropathy ( p < 0.001 ) . Conclusions : This study provides class IV evidence that CRP remains an efficient and long-lasting noninvasive treatment for BPPV , especially for younger patients without a history of head trauma or vestibular neuropathy . Elderly people have a significantly higher recurrence rate requiring additional education to minimize potential morbidity of their falls The aim of this study was to evaluate the effectiveness of a new technical variant applied to the Gufoni 's manoeuvre , in the treatment of horizontal canal benign paroxysmal positional vertigo ( HSC-BPPV ) . 87 patients with BPPV of HSC ( 55 women and 32 men ) , aged between 21 and 80 years , were r and omized either to modified Gufoni 's manoeuvre or to the Gufoni 's manoeuvre .  93 % of patients treated with modified Gufoni 's manoeuvre was cured after the first treatment session , of which only 2 % had a conversion into PSC-BPPV , while the Gufoni 's manoeuvre led to a symptoms resolution in 88 % of cases , of which 16 % had a conversion into PSC-BPPV . Therefore , the modified Gufoni 's manoeuvre shows the same effectiveness in the resolution of symptoms of Gufoni 's manoeuvre , but it appears more effective than the latter to reduce the percentage of conversion of the HSC-BPPV into PSC-BPPV ( χ 2 = 6.13 , P = 0.047 ) UNLABELLED Benign paroxysmal positional vertigo ( BPPV ) may compromise the balance of elderly subjects . OBJECTIVE To observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance . METHOD This is a prospect i ve clinical study . Patients diagnosed with BPPV ( Dix-Hallpike test ) were su bmi tted to the Timed Up & Go ( TUG ) test , the Clinical Test of Sensory Interaction and Balance ( CTSIB ) , and lower limb testing before and after they were repositioned using the modified Epley maneuver . RESULTS Most subjects were females , and the group 's mean age was 70.10 years ( SD = 7.00 ) . All patients had canalithiasis of the posterior canal . The following symptoms improved after the maneuver : postural instability ( p = 0.006 ) , nausea and vomiting ( p = 0.021 ) , and tinnitus ( p = 0.003 ) . Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver ( p < 0.001 ) . Patients performed better on the CTSIB after the Epley maneuver  on condition 2 ( p < 0.003 ) , condition 3 ( p < 0.001 ) , condition 4 ( p < 0.001 ) , condition 5 ( p < 0.001 ) , and condition 6 ( p < 0.001 ) . CONCLUSION Clinical and functional aspects of body balance in elderly with BPPV improved after treatment with the modified Epley maneuver The need for Class I and II studies on the efficacy of Semont ’s liberatory maneuver ( SLM ) in the treatment of posterior canal benign paroxysmal positional vertigo ( PC-BPPV ) motivated the present double-blind r and omized trial on the short-term efficacy of SLM . A total of 342 patients with unilateral PC-BPPV were recruited for a multicenter study . Patients were r and omly assigned to treatment by SLM ( n = 174 ) or sham treatment ( n = 168 ) . Subjects were followed up twice ( 1 and 24 h ) with the Dix – Hallpike maneuver by blinded examiners . At the 1 and 24 h follow-up , 79.3 and 86.8 % , respectively , of patients undergoing SLM had recovered from vertigo , compared to none of the patients undergoing the sham maneuver ( p < 0.0001 ) . Patients who manifested liberatory nystagmus at the end of SLM showed a significantly higher percentage of recovery ( 87.1 vs. 55.7 % ; p < 0.0001 ) . To the best of our knowledge , this is the first Class I study on the efficacy of SLM . SLM proved highly effective with respect to the sham maneuver ( p < 0.0001 ) . Liberatory nystagmus was demonstrated to be a useful prognostic factor for the efficacy of treatment . The present Class I study of efficacy of SLM changes the level of recommendation of the maneuver for treating PC-BPPV from level C to level OBJECTIVE In the present study , we calculated the success rate of the modified Epley maneuver and determined the effectiveness of post-maneuver positional restriction in terms of the prevention of early and late recurrence . METHODS The present study was conducted on 78 patients who had unilateral benign paroxysmal positional vertigo ( BPPV ) of the posterior semicircular canal ( SCC ) and who were treated in the Otorhinolaryngology Department of Susehri State Hospital . The Dix-Hallpike test was performed on all patients . After the involved canal was identified using this test , we guided patients through the modified Epley repositioning maneuver . A maximum of two maneuvers were performed in the same session . The patients were r and omly divided into two groups . One group was not advised any positional restriction , while the second group was advised positional restriction for 10 days after the procedure . Recurrences during 1 - 90 days after the treatment were noted as early recurrences , while those that occurred after 90 days were noted as late recurrences . RESULTS In the restriction group ( n=39 ) ,  repositioning  was successful after a single maneuver in 32 ( 82.05 % ) patients and after two maneuvers in 5 ( 12.8 % ) patients .  Repositioning failed in two ( 5.1 % ) patients . In the non-restriction group ( n=39 ) ,  repositioning  was successful after a single maneuver in 31 ( 79.4 % ) patients and after two maneuvers in 6 ( 15.3 % ) patients .  Repositioning failed in two ( 5.1 % ) patients . Thus , the success rate was 94.8 % in each group . Early recurrence occurred in 3 ( 8.1 % ) of 37 patients in the restriction group and 2 ( 5.4 % ) of 37 patients in the non-restriction group ( p>0.05 ) . Late recurrence occurred in 5 ( 13.5 % ) of 37 patients in both the restriction and non-restriction groups ( p>0.05 ) . CONCLUSION Postural restriction after a canalith repositioning procedure does not improve procedural success or decrease early and late recurrence rates . However , the number of patients was too small to detect a difference between both treatment groups Introduction . To compare the efficiency of Epley ( Ep ) and Sémont-Toupet ( ST ) repositioning maneuvers and to evaluate postmaneuver restriction effect on short-term vertigo and dizziness after repositioning maneuvers by an analog visual scale ( VAS ) in benign positional paroxysmal vertigo ( BPPV ) . Material and Methods . 226 consecutive adult patients with posterior canal BPPV were included . Patients were r and omized into 2 different maneuver sequence groups ( n = 113 ) : 2 ST then 1 Ep or 2 Ep then 1 ST . Each group of sequence was r and omized into 2 subgroups : with or without postmaneuver restrictions . Vertigo and dizziness were assessed from days 0 to 5 by VAS . Results . There was no difference between vertigo scores between Ep and ST groups . Dizziness scores were higher in Ep group during the first 3 days but became similar to those of ST group at days 4 and 5 . ST maneuvers induced liberatory signs more frequently than Ep ( 58 % versus 42 % resp . , P < 0.01 , Fisher 's test ) . After repositioning maneuvers , VAS scores decreased similarly in patients with and without liberatory signs . Postmaneuver restrictions did not influence VAS scores . Conclusion . Even if ST showed a higher rate of liberatory signs than Ep in this series , VAS scores were not influenced by these signs Abstract Conclusion : Vertigo treatment and rehabilitation chair ( TRV ) may be suggested as the first choice for patients with posterior canal benign paroxysmal positional vertigo ( p-BPPV ) . Objective : To investigate the short- and long-term treatment efficacy of the canalith repositioning procedure ( CRP ) versus TRV for patients with p-BPPV . Methods : A total of 165 patients with unilateral p-BPPV were assigned to either the CRP group or the TRV group . Patients were assessed at 1 week , 4 weeks , 3 months , and 6 months after their first treatment . The numbers of treatment sessions required for successful repositioning in both groups at 4 weeks , 3 months , and 6 months were recorded . Results : Treatment efficacy of patients in the TRV group was significantly better than that of patients in the CRP group 1 week after the first treatment . The number of treatment sessions needed for successful repositioning was significantly lower in the TRV group than in the CRP group at 4 weeks and 3 months after the first treatment Objective To compare the outcome and probability of recurrence in a series of patients with unilateral idiopathic benign paroxysmal positional vertigo of the posterior canal ( PC-BPPV ) that were r and omly treated by Br and t-Daroff exercise ( B-D exercise ) or by particle repositioning maneuver ( PRM ) .  Study Design R and omized prospect i ve clinical trial . Setting Tertiary referral center . Patients Patients were included in this study if they complained of vertigo and had been diagnosed as having unilateral idiopathic PC-BPPV for at least 1 week before Dix-Hallpike maneuver ( DHM ) , remained for 30 days in the r and omly assigned treatment , and had at least 48 months ’ follow-up . Intervention Forty-one patients were treated with a single PRM and 40 patients by B-D exercise . Main Outcome Measure Resolution of benign paroxysmal positional nystagmus on the DHM . The probability of recurrence was also studied . Results At Day 7 , DHM was negative in 80.5 % of the PRM-treated patients and in 25 % of those treated by B-D exercise ( p < 0.001 ) . At Month 1 , the differences between both treatment groups remained statistically significant ( 92.7 % in PRM versus 42.5 % in the B-D exercise had a negative DHM ; p < 0.001 ) . The variable that influenced that DHM became negative was the PRM ( RR = 4.8 ; 95 % confidence interval , 2.5–9.2 ; p < 0.001 ) . The number of recurrences in PRM and B-D exercise were 0.56 ± 0.8 and 0.48 ± 0.8 , respectively ( p = 0.48 ) . The recurrence rate at 48 months was 35.5 % ( 15/41 ) in B-D exercise and 36.6 % ( 9/3 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To establish a possible causal factor for residual dizziness ( RD ) after successful repositioning maneuvers in patients with benign paroxysmal positional vertigo ( BPPV ) . Material s and Method : Ninety consecutive patients with idiopathic BPPV were treated with repositioning maneuvers , and the rate of RD was assessed as well as clinical data .  Posturography and assessment of anxiety levels were performed on patients reporting RD . Results were compared with a control group of BPPV patients of the sample after repositioning maneuvers and without RD . Results : Twenty-eight subjects ( 31.1 % ) reported RD on the second day after successful repositioning maneuvers . The mean duration of RD was 11.6 ± 3.9 days . Patients with RD presented a higher duration of BPPV ( 14.1 vs. 10.9 days , p = 0.01 ) . A correlation was demonstrated between the duration of BPPV and duration of RD ( p < 0.01 ) . Subjects with RD presented increased body sways , above all in eyes-closed conditions . Conclusion : RD is mainly correlated with duration of vertigo in BPPV patients . Anxiety was demonstrated to play a role in increased body sways Background : Canalith repositioning procedure ( CRP ) has increasingly been utilized for the last 15 years for the treatment of benign paroxysmal positional vertigo ( BPPV ) . We assess the short- and long-term efficacy of CRP on the treatment of patients with BPPV . Methods : Nine hundred sixty-five patients ( 481 men and 484 women , from 18 to 87 years of age ) were enrolled in this prospect i ve study during 1995–2010 . Inclusion criteria were a patient history compatible with BPPV and a positive provocative maneuver ( either Dix-Hallpike or Roll test ) . Reported duration of symptoms at the time of their first examination varied from 1 day to 18 months . Variants of the Epley and Barbeque maneuver were used for posterior and anterior canal involvement , and horizontal canal involvement , respectively . Short-term follow-up was obtained 48 h and 7 days after initial treatment , whereas long-term follow-up was obtained at repeated 6-month intervals . Results : Symptoms subsided immediately in 819 patients ( 85 % ) by the first CRP . Only 19 patients ( 2 % ) required CRP more than 3 times . Patients ’ mean follow-up was 74 months ; symptom recurrence was noted in 139 patients . A statistically significantly higher recurrence rate was noted in elderly people or those with head trauma or a history of vestibular neuropathy ( p < 0.001 ) . Conclusions : This study provides class IV evidence that CRP remains an efficient and long-lasting noninvasive treatment for BPPV , especially for younger patients without a history of head trauma or vestibular neuropathy . Elderly people have a significantly higher recurrence rate requiring additional education to minimize potential morbidity of their falls The aim of this study was to evaluate the effectiveness of a new technical variant applied to the Gufoni 's manoeuvre , in the treatment of horizontal canal benign paroxysmal positional vertigo ( HSC-BPPV ) . 87 patients with BPPV of HSC ( 55 women and 32 men ) , aged between 21 and 80 years , were r and omized either to modified Gufoni 's manoeuvre or to the Gufoni 's manoeuvre .  93 % of patients treated with modified Gufoni 's manoeuvre was cured after the first treatment session , of which only 2 % had a conversion into PSC-BPPV , while the Gufoni 's manoeuvre led to a symptoms resolution in 88 % of cases , of which 16 % had a conversion into PSC-BPPV . Therefore , the modified Gufoni 's manoeuvre shows the same effectiveness in the resolution of symptoms of Gufoni 's manoeuvre , but it appears more effective than the latter to reduce the percentage of conversion of the HSC-BPPV into PSC-BPPV ( χ 2 = 6.13 , P = 0.047 ) UNLABELLED Benign paroxysmal positional vertigo ( BPPV ) may compromise the balance of elderly subjects . OBJECTIVE To observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance . METHOD This is a prospect i ve clinical study . Patients diagnosed with BPPV ( Dix-Hallpike test ) were su bmi tted to the Timed Up & Go ( TUG ) test , the Clinical Test of Sensory Interaction and Balance ( CTSIB ) , and lower limb testing before and after they were repositioned using the modified Epley maneuver . RESULTS Most subjects were females , and the group 's mean age was 70.10 years ( SD = 7.00 ) . All patients had canalithiasis of the posterior canal . The following symptoms improved after the maneuver : postural instability ( p = 0.006 ) , nausea and vomiting ( p = 0.021 ) , and tinnitus ( p = 0.003 ) . Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver ( p < 0.001 ) . Patients performed better on the CTSIB after the Epley maneuver  on condition 2 ( p < 0.003 ) , condition 3 ( p < 0.001 ) , condition 4 ( p < 0.001 ) , condition 5 ( p < 0.001 ) , and condition 6 ( p < 0.001 ) . CONCLUSION Clinical and functional aspects of body balance in elderly with BPPV improved after treatment with the modified Epley maneuver The need for Class I and II studies on the efficacy of Semont ’s liberatory maneuver ( SLM ) in the treatment of posterior canal benign paroxysmal positional vertigo ( PC-BPPV ) motivated the present double-blind r and omized trial on the short-term efficacy of SLM . A total of 342 patients with unilateral PC-BPPV were recruited for a multicenter study . Patients were r and omly assigned to treatment by SLM ( n = 174 ) or sham treatment ( n = 168 ) . Subjects were followed up twice ( 1 and 24 h ) with the Dix – Hallpike maneuver by blinded examiners . At the 1 and 24 h follow-up , 79.3 and 86.8 % , respectively , of patients undergoing SLM had recovered from vertigo , compared to none of the patients undergoing the sham maneuver ( p < 0.0001 ) . Patients who manifested liberatory nystagmus at the end of SLM showed a significantly higher percentage of recovery ( 87.1 vs. 55.7 % ; p < 0.0001 ) . To the best of our knowledge , this is the first Class I study on the efficacy of SLM . SLM proved highly effective with respect to the sham maneuver ( p < 0.0001 ) . Liberatory nystagmus was demonstrated to be a useful prognostic factor for the efficacy of treatment . The present Class I study of efficacy of SLM changes the level of recommendation of the maneuver for treating PC-BPPV from level C to level OBJECTIVE In the present study , we calculated the success rate of the modified Epley maneuver and determined the effectiveness of post-maneuver positional restriction in terms of the prevention of early and late recurrence . METHODS The present study was conducted on 78 patients who had unilateral benign paroxysmal positional vertigo ( BPPV ) of the posterior semicircular canal ( SCC ) and who were treated in the Otorhinolaryngology Department of Susehri State Hospital . The Dix-Hallpike test was performed on all patients . After the involved canal was identified using this test , we guided patients through the modified Epley repositioning maneuver . A maximum of two maneuvers were performed in the same session . The patients were r and omly divided into two groups . One group was not advised any positional restriction , while the second group was advised positional restriction for 10 days after the procedure . Recurrences during 1 - 90 days after the treatment were noted as early recurrences , while those that occurred after 90 days were noted as late recurrences . RESULTS In the restriction group ( n=39 ) ,  repositioning  was successful after a single maneuver in 32 ( 82.05 % ) patients and after two maneuvers in 5 ( 12.8 % ) patients .  Repositioning failed in two ( 5.1 % ) patients . In the non-restriction group ( n=39 ) ,  repositioning  was successful after a single maneuver in 31 ( 79.4 % ) patients and after two maneuvers in 6 ( 15.3 % ) patients .  Repositioning failed in two ( 5.1 % ) patients . Thus , the success rate was 94.8 % in each group . Early recurrence occurred in 3 ( 8.1 % ) of 37 patients in the restriction group and 2 ( 5.4 % ) of 37 patients in the non-restriction group ( p>0.05 ) . Late recurrence occurred in 5 ( 13.5 % ) of 37 patients in both the restriction and non-restriction groups ( p>0.05 ) . CONCLUSION Postural restriction after a canalith repositioning procedure does not improve procedural success or decrease early and late recurrence rates . However , the number of patients was too small to detect a difference between both treatment groups Introduction . To compare the efficiency of Epley ( Ep ) and Sémont-Toupet ( ST ) repositioning maneuvers and to evaluate postmaneuver restriction effect on short-term vertigo and dizziness after repositioning maneuvers by an analog visual scale ( VAS ) in benign positional paroxysmal vertigo ( BPPV ) . Material and Methods . 226 consecutive adult patients with posterior canal BPPV were included . Patients were r and omized into 2 different maneuver sequence groups ( n = 113 ) : 2 ST then 1 Ep or 2 Ep then 1 ST . Each group of sequence was r and omized into 2 subgroups : with or without postmaneuver restrictions . Vertigo and dizziness were assessed from days 0 to 5 by VAS . Results . There was no difference between vertigo scores between Ep and ST groups . Dizziness scores were higher in Ep group during the first 3 days but became similar to those of ST group at days 4 and 5 . ST maneuvers induced liberatory signs more frequently than Ep ( 58 % versus 42 % resp . , P < 0.01 , Fisher 's test ) . After repositioning maneuvers , VAS scores decreased similarly in patients with and without liberatory signs . Postmaneuver restrictions did not influence VAS scores . Conclusion . Even if ST showed a higher rate of liberatory signs than Ep in this series , VAS scores were not influenced by these signs Abstract Conclusion : Vertigo treatment and rehabilitation chair ( TRV ) may be suggested as the first choice for patients with posterior canal benign paroxysmal positional vertigo ( p-BPPV ) . Objective : To investigate the short- and long-term treatment efficacy of the canalith repositioning procedure ( CRP ) versus TRV for patients with p-BPPV . Methods : A total of 165 patients with unilateral p-BPPV were assigned to either the CRP group or the TRV group . Patients were assessed at 1 week , 4 weeks , 3 months , and 6 months after their first treatment . The numbers of treatment sessions required for successful repositioning in both groups at 4 weeks , 3 months , and 6 months were recorded . Results : Treatment efficacy of patients in the TRV group was significantly better than that of patients in the CRP group 1 week after the first treatment . The number of treatment sessions needed for successful repositioning was significantly lower in the TRV group than in the CRP group at 4 weeks and 3 months after the first treatment Objective To compare the outcome and probability of recurrence in a series of patients with unilateral idiopathic benign paroxysmal positional vertigo of the posterior canal ( PC-BPPV ) that were r and omly treated by Br and t-Daroff exercise ( B-D exercise ) or by particle repositioning maneuver ( PRM ) .  Study Design R and omized prospect i ve clinical trial . Setting Tertiary referral center . Patients Patients were included in this study if they complained of vertigo and had been diagnosed as having unilateral idiopathic PC-BPPV for at least 1 week before Dix-Hallpike maneuver ( DHM ) , remained for 30 days in the r and omly assigned treatment , and had at least 48 months ’ follow-up . Intervention Forty-one patients were treated with a single PRM and 40 patients by B-D exercise . Main Outcome Measure Resolution of benign paroxysmal positional nystagmus on the DHM . The probability of recurrence was also studied . Results At Day 7 , DHM was negative in 80.5 % of the PRM-treated patients and in 25 % of those treated by B-D exercise ( p < 0.001 ) . At Month 1 , the differences between both treatment groups remained statistically significant ( 92.7 % in PRM versus 42.5 % in the B-D exercise had a negative DHM ; p < 0.001 ) . The variable that influenced that DHM became negative was the PRM ( RR = 4.8 ; 95 % confidence interval , 2.5–9.2 ; p < 0.001 ) . The number of recurrences in PRM and B-D exercise were 0.56 ± 0.8 and 0.48 ± 0.8 , respectively ( p = 0.48 ) . The recurrence rate at 48 months was 35.5 % ( 15/41 ) in B-D exercise and 36.6 % ( 9/3 
    Output:
    