For all techniques, consider the patient's ability to tolerate testing and treatment position's prior.  Bhattacharyya et al., 2008 reccommends the clinician use caution and potentially avoid using the Dix-Hallpike if:

 

​-Significant vascular injury risk factors are present

-cervical stenosis, severe kyphoscoliosis

-Limited cervical range of motion

-Down syndrome

-Severe rheumatoid arthritis

-Cervical radiculopathies

-Paget's disease

-Ankylosing spondylitis

-Low back dysfunction

-Spinal cord injuries

-morbid obesity