Beyond the Maneuver: Impact of Structured Counselling on Functional Recovery in Benign Paroxysmal Positional Vertigo

This study assessed the effect of supplementing Canalith Repositioning Maneuvers (CRM) with structured counselling on functional recovery in patients with Benign Paroxysmal Positional Vertigo (BPPV).

In this prospective, controlled study, sixty patients with posterior or lateral canal BPPV underwent appropriate CRM. Patients were randomly allocated to receive either CRM alone or CRM combined with structured counselling. Functional recovery was assessed using the Dizziness Handicap Inventory (DHI) at baseline and one week after treatment. Handicap recovery was calculated as the change in DHI score (ΔDHI). Multivariate linear regression analysis was performed to determine whether counselling independently predicted handicap recovery after adjusting for age, sex, canal involvement, and baseline DHI severity.

Both groups showed significant DHI improvement after-CRM. However, the Intervention Group demonstrated a significantly greater mean ΔDHI (28.80 ± 3.13) compared to the Control Group (22.47 ± 4.66), with a mean difference of 6.33 point (p < 0.001). Furthermore, fewer patients in the Intervention Group (6.7% vs. 20%) returned to the clinic prematurely with concerns about persistent symptoms. After multivariate adjustment, structured counselling remained an independent predictor of greater handicap recovery (β = 5.07; 95% CI: 3.15-6.98; p < 0.001). Baseline DHI severity was also independently associated with recovery (p < 0.001), age, sex, and canal involvement were not significant predictors.

Structured post-maneuver counselling independently enhances early functional recovery in patients with BPPV beyond the effect of CRM alone. Incorporating counselling into routine BPPV management may improve patient-perceived outcomes during the early recovery phase.