Contribution of the repositioning chair in the treatment of patients with benign paroxysmal positional vertigo: a systematic review and meta-analysis

BACKGROUND: Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo and is predominantly treated by using manual repositioning maneuvers. Although effective, these techniques may be limited by patient tolerance, physical constraints, or difficulties in diagnosis. AIMS/OBJECTIVES: This study aimed to assess the clinical and practical advantages of using a repositioning chair for treating benign paroxysmal positional vertigo, compared with conventional techniques. MATERIAL AND METHODS: A systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, Embase, and Web of Science. Study quality was evaluated using the Newcastle-Ottawa Scale and the PEDro scale, and the meta-analysis quantified the chair's therapeutic efficacy. RESULTS: Twelve studies including 1,385 patients were analyzed. Complete resolution rates ranged from 54% to 100%. Meta-analysis of nine studies showed a pooled success rate of 71.5% after one session and 91.4% cumulatively. Disability improved significantly (SMD 1.56). Residual dizziness occurred in 16.1% of patients, and recurrence in 16%. Sensitivity analyses confirmed robust results despite heterogeneity, with overall moderate to high methodological quality. CONCLUSIONS AND SIGNIFICANCE: Repositioning chairs appears to be effective tools for the management of benign paroxysmal positional vertigo, particularly in complex or refractory cases.