Data from a UK-based multicentre randomised feasibility study investigating the management of post-traumatic benign paroxysmal positional vertigo: mixed-methods analyses
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Published version
Author(s)
Type
Journal Article
Abstract
Objectives Traumatic brain injury commonly causes dizziness and balance problems. Benign paroxysmal positional vertigo (BPPV) is the most frequent cause of inner-ear related post-traumatic vestibular dysfunction. However, optimal assessment and treatment practices are poorly evidenced. Using a mixed methods approach, we aimed to explore the feasibility of managing post-traumatic BPPV.
Design A mixed-methods randomised feasibility study. In this paper, quantitative and qualitative data relating to key feasibility targets around recruitment, randomisation and assessment and treatment were selected and integrated to provide an in-depth understanding of BPPV management.
Setting Three UK major trauma centres
Participants Hospitalised adults with post-traumatic BPPV.
Interventions Patients were randomised to one of three interventions (repositioning manoeuvres, Brandt-Daroff exercises and advice).
Results Screening and recruitment varied between sites due to individual and site-specific factors. Randomisation to advice was experienced differently by healthcare professionals and patients, suggesting that changes to the study design of a future effectiveness trial may be required. Assessment and treatment were acceptable to participants, supporting advancement to an effectiveness trial.
Conclusions Integration of qualitative and quantitative data revealed new findings relating to the primary outcomes of the feasibility study, while strengths and weaknesses of the trial design were also elucidated. Taken together, such data will influence and enhance the design of a future trial.
Trial registration number ISRCTN91943864.
Design A mixed-methods randomised feasibility study. In this paper, quantitative and qualitative data relating to key feasibility targets around recruitment, randomisation and assessment and treatment were selected and integrated to provide an in-depth understanding of BPPV management.
Setting Three UK major trauma centres
Participants Hospitalised adults with post-traumatic BPPV.
Interventions Patients were randomised to one of three interventions (repositioning manoeuvres, Brandt-Daroff exercises and advice).
Results Screening and recruitment varied between sites due to individual and site-specific factors. Randomisation to advice was experienced differently by healthcare professionals and patients, suggesting that changes to the study design of a future effectiveness trial may be required. Assessment and treatment were acceptable to participants, supporting advancement to an effectiveness trial.
Conclusions Integration of qualitative and quantitative data revealed new findings relating to the primary outcomes of the feasibility study, while strengths and weaknesses of the trial design were also elucidated. Taken together, such data will influence and enhance the design of a future trial.
Trial registration number ISRCTN91943864.
Date Issued
2026-06-01
Date Acceptance
2026-05-15
Citation
BMJ Open, 2026, 16 (6)
ISSN
2044-6055
Publisher
BMJ
Journal / Book Title
BMJ Open
Volume
16
Issue
6
Copyright Statement
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.
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Publication Status
Published
Article Number
e117657
Date Publish Online
2026-06-16