When I was a graduate student learning how to become a professional physical therapist, I became aware of the importance of evidence-based clinical practice and applying research findings to inform clinical decision making. 

I have observed that a hot topic in current healthcare is evidence-based clinical practice.

As a true, super nerd who literally reads research articles on my leisure time and for bedtime reading, I am SO EXCITED about the newly revised 2017 BPPV Clinical Practice Guidelines.

This very important document represents the evidence-based clinical practice recommendations created by a committee sponsored by the American Academy of Otolaryngologists – Head and Neck Surgery Foundation.

The 2017 publication is an update to the original evidence-based clinical practice guidelines released in 2008.

In my work educating other physical therapists and healthcare providers on best practices for assessment and treatment of dizziness, vertigo, imbalance and unexplained repeated falls, I emphasize some of the key findings and recommendations of the committee.

Some of the Key findings about BPPV include:

  • Many patients with BPPV are misdiagnosed or under-diagnosed, due to lack of proper root cause evaluation for patients with complaints of dizziness and vertigo.
  • The revised BPPV evidence-based clinical practice guidelines is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies in all clinical practice settings where dizziness or vertigo would be managed.
  • To arrive at a diagnosis of BPPV, the average cost is $2,000. Many patients undergo unnecessary diagnostic testing and inappropriate or ineffective treatments, resulting in prolonged delays in care.
  • Delays in appropriate diagnosis and treatment have a significant cost and reduce the quality of life for the patient AND their caregivers.
  • Due to the prevalence of BPPV, especially in the elderly, the societal impacts are TREMENDOUS.
  • Older people with BPPV have a higher incidence of depression, falls and reduced daily activity levels.
  • With the increasing age of the US population, the incidence and prevalence of BPPV is expected to increase.
  • Several other disorders may present similarly to BPPV, and should be considered as part of a comprehensive exam. BPPV can also co-exist with these disorders and none of these potential causes should be overlooked.
  • The diagnosis and immediate treatment of BPPV can be made based on the clinical history and physical exam by a properly trained clinician without any specialized testing equipment.
  • There is still a need for research to determine the rates of falls with BPPV as the underlying diagnosis.

If you are interested in reading – or sharing – the 2017 BPPV Clinical Practice Guidelines, click here.

To learn more about common symptoms of BPPV, click here.


This blog is provided for informational and educational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.

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