Management of Benign Paroxysmal Positional Vertigo: Knowledge and Practice among Physicians and Physical Therapists in Saudi Arabia

Abstract Background: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, with effective management depending on adherence to clinical practice guidelines (CPGs). However, evidence suggests variability in the awareness and application of recommended diagnostic and treatment maneuvers among healthcare providers. This study aimed to assess the knowledge and clinical practices of physicians and physical therapists in Saudi Arabia regarding BPPV management. Materials and Methods: A cross-sectional questionnaire survey was conducted among 134 clinicians. The survey assessed professional characteristics, knowledge of BPPV diagnostic and treatment maneuvers, and referral practices. Associations between characteristics and outcomes were examined using Chi-square tests, with odds ratios and 95% confidence intervals (CIs) calculated. Binary logistic regression was applied to identify factors associated with familiarity and performance of BPPV maneuvers. Results: Of the respondents, 66.4% were aware of BPPV CPGs. While familiarity with diagnostic and treatment maneuvers was relatively high, their application in practice was lower. Only 3.7% of physicians referred patients to physical therapy, primarily due to a lack of awareness. Specialty, postgraduate degree, work setting, and awareness of CPGs were significantly associated with greater knowledge and practice. Logistic regression identified that age, specialty, postgraduate degree, and CPGs awareness were associated with familiarity, while gender, work setting, and experience were associated with performance. Conclusion: Clinicians demonstrated good knowledge of BPPV management, but limited application and referral practices. These findings highlight the need for structured, hands-on training workshops and educational initiatives to enhance clinical competence and promote the role of physical therapy in vestibular rehabilitation.