Position 1:  Patient begins sitting on table in an upright position.



Position 2:  Patient is brought to a position so the head is extended 60 degrees off of the table (picture shows 30 degrees).  This is maintained for 30 seconds once vertigo has subsided.  



Position 3:  Patient rapidly tucks their chin to their chest, (forming an angle of about 30 degrees above horizontal).  



Position 4:  Patient is brought to upright sitting



Evidence:  



This procedure makes sense anatomically, as the chin tucked position should allow debris to fall out of the anterior canal.   In the article by Yacovino, Hain, & Gualtieri 2009, 13 patient's were given this technique, and 84.6% became symptom free after a single maneuver (11/13).  2/13 patients became symptom free after an additional maneuver.  Additionally, Casani, Cerchiai, Dallan, & Sellari-Franceschini, 2010  examined this technique on 17 patients.  8 patients were symptom free after 1 session of treatment, 7 needed 2 sessions of treatment, and 2 more required three treatments.  1 patient did not achieve resolution of symptoms.