Epley Maneuver: Performed on a Real Patient suffering from Vertigo

Hi, I’m Bob Schrupp physical therapist
and I’m Brad Heineck physical therapist And together we are the most famous physical therapists on the internet Why in our opinion of course, Bob
and we’re doing something completely new today And Julie’s gonna be part of it.
-This is exciting This is exciting we’re breaking new ground here
Julie kinda is helping– she works with us And she was telling us today that she’s having some vertigo. Some spinning, you lose your balance, right? I mean you’re kind of worried you’re gonna fall over
-Yeah if I move fast, yes So we’re gonna go ahead and do a quick test on her to see if she maybe has BPPV benign positional Proximal… you always say it differently yeah -Vertigo
-Vertigo [laughing] We’re gonna see if she has vertigo
We’re gonna see if she is the most common one so we’re gonna do what is called a dix hallpike maneuver on her and We’re gonna see if she has a little bit of dizziness here, so Julie why don’t you come over here and scoot back a little bit further right there Now we already, to be honest, we did we already did one direction off of camera We turned her head this way, and then we brought her back now, and she got very dizzy with that Very– so we’re gonna try the other direction to see if she gets dizzy with that also I think I’m going to have you take your glasses off So we’re turning her head 45 degrees to the left and then I’m gonna go ahead and bring her back really quickly here You ready? Okay, Julie come on back -No, I’m not dizzy this time. -And she was very dizzy when we did this the other direction, so we now know which way we have to go So why don’t you come on back up So she— when I turned her head this way and I brought her back That’s when she had– she really started spinning. You didn’t get nauseated, but you got very, very– -She needed to hang on to something
when she’s feeling it to not lose her balance We’re gonna go ahead and do the Epley maneuver on her here, which we have a video on it already but we’re gonna do this to see if we What’s going to happen here So you can see it happen on the live patient So again she’s gonna tilt her head 45 degrees to the left and then when I bring her down,
we’re gonna have it tilted back 20 degrees -45 to the right or to the left?
-45 to the right. What did I say?
Left 45 to the right
[laughing] And then tilt their head back 10 degrees okay here we go Julie. You’re not gonna like this Okay watch her up look at her eyes Brad Her eyes are twitching back and forth they call that nystagmus I’m timing here. We got about 15 seconds. We’re waiting to tell the eyes are calming down and now they’re calming down Do you feel it kind of going away?
Yeah and now I see nothing and you feel like it’s gone away?
Yup Okay now I’m gonna tilt their head this way again 45 degrees to the left 20 degrees down —And no symptoms at all?
—No, not too much —A little bit?
—Yeah just after you turned it a little bit then it was ok So the idea is we’re going to wait until the symptoms Go away for 20 to 30 seconds.
Ok now I’m going to have you roll over onto your shoulder Which way? To your left And we’re going to keep your head down
We’ll bring your head down like this All the way down Good – How are you doing?
– Okay -Are you getting symptoms now?
-Nope I did a little bit when I rolled but not right now
-okay Wait a few more just to be sure Okay, let’s come on up and we’ll keep your head turned -You okay?
-Yeah Just a little bit dizzy A little bit dizzy? You can see it on her eyes, boy her eyes were really going on that first one that first one -Still?
-A little bit -The room spinning or…?
-No it was just a little bit dizzy not like before Now it’s pretty good Ok I’m going to go to the middle.
Now for the rest of the day You can’t look down at all. A lot of times we’ll have people maybe wear a neck brace or I take sometimes a rolled towel and just pin it there And yeah, and just to remind them not to look down and believe me they will forget because
-Yeah because it’s natural I had a lady the other day I’m not kidding ten seconds after I told her,
she reached down and grabbed her purse I repeated it like 10 times.
Do not look down. She went down and looked at her purse.
So you can look down with your eyes, But you can’t look- then tonight you want to sleep on a bunch of pillows if you can Kind of elevated and do that for one night then tomorrow you can do whatever you want -okay
-okay? So what I always do I just tell them to go to the har-
Hah the hardware store… Go to the drugstore, the pharmacy and buy a soft cushion collar. They cost about ten or fifteen dollars and Just bring it along because there’s gonna
you know- Just to prevent it, and I put it on right now Then they walk out with it I– to be honest I would possibly even do it again on her Because she had little symptoms coming up But I think we’ll try it without what but we may have to redo it I think it’s like twenty percent you have to redo it another time But you know the results are usually fairly dramatic It usually can get rid of it a lot of times with one setting or about two settings And how long does she need to keep her head up without looking down? Until till tonight, okay All the way until she goes to bed Tomorrow morning she can look down again and we’ve got, on another video, we’re saying 48 hours right and that’s what it used to be and Now there’s they’re recommending that you could you could do it Just for ’til the end of the day so But we’ve had people call and say they have they’ve had success only if they did 48 hours I have had people that have said that to me but it might have been the fact that they just did it the rest of the day right Know I mean?
Sure so we don’t know, so Thanks, Julie. We’ll check on you to see how it goes but we’ll– We may have to redo this if it doesn’t hold Okay Don’t shake your head up and down [laughing] Just say okay Thanks a lot


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