Table 1.

Treatments offered with the MRC-1 chair.

Repositioning maneuver	Maneuver description	BPPV subtype eligible for this treatment
Modified Epley maneuver	Positioned with the head 30–45° below horizontal level and body (head) rotated 45° toward the affected side (DH position). Followed by four consecutive 45° rotations toward the healthy side with a total of a 180° rotation toward the healthy side. Every position was kept for 30–60 s or until positional nystagmus disappeared.	Posterior CAN
Potentiated Epley maneuver	Same approach as the modified Epley, but 10 impulses, adding kinetic force, were applied in addition in all five positions. Impulses were added by bumping the seat vertically into an attached shock absorber 45° below horizontal level.	Posterior CAN and CUP
Semont maneuver	Same starting position as the modified Epley, but instead of consecutive rotations in the yaw axis (minutes), the patient is rotated 270° in the pitch axis in one fast (few seconds) turn with an abrupt stop against the attached shock absorber on the opposite side. Can be performed with or without impulses in the starting position.	Posterior CAN and CUP
Shock treatment for lateral BPPV*	For treatment of lateral CAN begin with body (head) rotated 45° toward the affected side and the body positioned horizontally. Ten impulses are applied in this position and treatment is continued by four consecutive 45° rotations toward the healthy side with impulses (kinetic energy) added in each position. For treatment of lateral CUP the same approach is used. However, treatment of lateral CUP is initiated with the body (head) rotated an additional 45° toward the affected side.	Lateral CAN and CUP
Dynamic barbeque roll	Supine position followed by a 90° rotation toward the affected side. The patient is rotated 360° ten times toward the healthy side with accelerations and deaccelerations included in every rotation.	Lateral CAN and CUP
Deep head hanging maneuver	Body (head) rotated 45° toward the un-affected side. Then a fast forward or backward 180° rotation in the pitch axis is performed. Can be performed with or without impulses before 180° rotation. The maneuver can also be done without any 45° rotation before the 180° rotation in the pitch axis if treatment is intended for patients without unambiguous laterality.	Anterior CAN and CUP
Maneuver for treatment resistant BPPV	The patient is placed in the supine position (lateral BPPV) or further 45° downwards in the pitch axis. The patient is then rotated 135° toward the affected side in the yaw axis. Following treatment in this position the patient is rotated toward the healthy side seven times with 45° intervals. In all eight positions 20 impulses are applied	Posterior and lateral, CAN and CUP
Individualized maneuver	Fewer or more rotational steps and/or impulses with the Epley maneuver or shock treatment due to patient related conditions.	Posterior and lateral, CAN and CUP

^*Performed in supine horizontal positioning from June 2019 and onwards. CAN, canalolithiasis; CUP, cupulolithiasis.