With the TRV chair the effectiveness of these maneuvers can be enhanced by following the exact plane of the canal, and by adding kinetic energy to the liberatory maneuver. The kinetic energy will accelerate the movement of the smaller otoconia that would otherwise remain in their original location. This is often the only way to treat patients with residual lateral canalithiasis linked to a very few otoliths in the canal resulting in a weaker positional nystagmus despite strong symptoms.

The kinetic energy is added by driving the main arm of the TRV chair against a hydraulic stop in each sequence in the liberatory maneuver; this produces a mild de-acceleration which is sufficient to free even the smallest otoconia and secure a successful treatment.

Kinetic energy is also applied in the Dynamic BBQ Maneuver (DBM). DBM is a series of 2 x 7 rotations around the vertical axis with shifts between acceleration and deceleration; a highly effective treatment of lateral canal BPPV.