The Segmont Diagnostic Maneuver diagnoses Benign Paroxysmal Positional Vertigo (BPPV).
5 minutes
5 Minutes or Less
Karen Lambert, PT, MPT, NCS, Linda B. Horn, PT, DScPT, MHS, NCS and the Neurology Section Vestibular EDGE Task Force of the American Physical Therapy Association.
The side-lying test can be used as an alternative to the Dix-Hallpike maneuver when the patient cannot tolerate the latter due to postural restrictions, medical precautions, or discomfort. There have been very few studies looking specifically at the Side-Lying Test. As with any positional test, true BPPV may be missed due to the transient nature of this diagnosis among other reasons.
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Vestibular Disorders
Concurrent Validity - (Cohen, 2004, n = 61; 14 males, 47 females; mean age = 56.2 (16) years; all subjects reported experiencing vertigo when looking up, down, or rolling over in bed)
(Halker, 2008, performed a critical appraisal of diagnostic maneuvers for BPPV and further analyzed Cohen, 2004 article)
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Side-Lying Value (95% CI) |
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Prevalence |
87.9% |
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Sensitivity |
89.7% (78.6-100) |
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Specificity |
75.0% (32.6-100) |
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Positive predictive value |
96.3% (89.2-100) |
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Negative predictive value |
50.0% (10.0-90.0) |
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Overall accuracy |
87.9% (76.7-99.0) |
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Positive likelihood ratio LR+) |
3.59 (0.65-19.67) |
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Negative likelihood ration LR-) |
0.14 (0.04-0.46) |
Concurrent Validity - (Cohen, 2004)
Cohen, H. S. (2004). "Side-lying as an alternative to the Dix-Hallpike test of the posterior canal." Otology & Neurotology 25(2): 130-134.
Halker, R. B., Barrs, D. M., et al. (2008). "Establishing a diagnosis of benign paroxysmal positional vertigo through the Dix-Hallpike and side-lying maneuvers: a critically appraised topic." The neurologist 14(3): 201-204.
Helminski, J. O., Janssen, I., et al. (2008). "Daily exercise does not prevent recurrence of benign paroxysmal positional vertigo." Otology & Neurotology 29(7): 976-981.
Helminski, J. O., Zee, D. S., et al. (2010). "Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review." Phys Ther 90(5): 663-678. Find it on PubMed
Lee, S. H. and Kim, J. S. (2010). "Benign paroxysmal positional vertigo." Journal of Clinical Neurology 6(2): 51-63.
Noda, K., Ikusaka, M., et al. (2011). "Predictors for benign paroxysmal positional vertigo with positive Dix-Hallpike test." Int J Gen Med 4: 809-814. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.