Evaluation of effective methods in the treatment of residual dizziness after BPPV: a randomized comparative clinical...

This study investigated the efficacy of vestibular rehabilitation therapy (VRT) and Theta Binaural Beats (T-BB) in reducing dizziness and anxiety in patients with residual dizziness (RD) following successful canalith repositioning procedures (CRP) for posterior canal benign paroxysmal positional vertigo (BPPV).

In a prospective controlled design, 56 adults (35 females), aged 18-60, with imbalance lasting ≥ 20 days after CRP were recruited from a tertiary care otolaryngology clinic. Participants were assigned to one of three groups: Cawthorne-Cooksey Exercises (CCE), Brandt-Daroff Exercises (BDE), or CCE with T-BB (CCE + BB). Interventions were home-based; CCE groups followed a six-week protocol, while BDE was delivered over four weeks. The Sensory Organization Test (SOT) was used for objective evaluation. Subjective outcomes included the Dizziness Handicap Inventory (DHI) and State-Trait Anxiety Inventory (STAI).

All groups demonstrated significant improvement in SOT Vestibular and Composite scores (p < 0.05). The greatest improvements in ΔVisual, ΔVestibular, and ΔComposite scores were observed in the CCE + BB group, while the BDE group demonstrated the least progress across these domains. ΔDHI Total and Emotional scores improved in all groups; however, ΔDHI Functional and Physical subscales improved only in both CCE groups. STAI-II (Trait) scores decreased across all groups, while STAI-I (State) significantly decreased in both CCE groups but not in the BDE group.

RD is often under-recognised due to the absence of detectable vestibular pathology, despite its psychological impact. This original study demonstrates that while CCE was more effective than BDE, the integration of T-BB further reduced anxiety and enhanced vestibular recovery, supporting the value of a personalized multimodal rehabilitation approach.