Effects of Virtual Reality Assisted Vestibular Rehabilitation Versus Conventional Vestibular Rehabilitation on Dizziness, Balance, and Gait in Patients With Benign Paroxysmal Positional Vertigo

NCT07703085 | Active Not Recruiting DMC

• 1 other identifier: UBAS/ERB/26/04/037
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the effectiveness of two rehabilitation techniques-Virtual Reality-assisted Vestibular Rehabilitation and Conventional Vestibular Rehabilitation-in improving dizziness, balance, and gait in patients with Benign Paroxysmal Positional Vertigo (BPPV). BPPV is a common vestibular disorder that leads to episodes of dizziness, impaired balance, and gait instability, significantly affecting daily activities and quality of life. Although conventional vestibular rehabilitation is widely used, newer approaches such as Virtual Reality (VR) may provide enhanced outcomes through immersive and interactive training environments. Participants diagnosed with BPPV will be randomized into two groups: Group 1 will receive Virtual Reality-assisted vestibular rehabilitation along with routine physical therapy, and Group 2 will receive conventional vestibular rehabilitation along with routine physical therapy. The interventions will be conducted multiple times per week for a specified duration, and participants will undergo assessments for dizziness, balance, and gait before and after the intervention. Outcome measures will include tools such as the Dizziness Handicap Inventory (DHI), Berg Balance Scale (BBS), and Timed Up and Go (TUG) test. The study will compare the effects of both rehabilitation approaches, focusing on symptom reduction and functional improvement. The findings may contribute to improved rehabilitation protocols and enhance the quality of life for patients with BPPV.

Conditions

Benign Proximal Positional Vertigo (BPPV)

Keywords

neuromuscular rehabilitation sensory augmentation neuromodulation neuroplasticity BPPV VR- assisted rehabilitation Dizziness Vertigo Gait

Outcome Measures

Primary Outcomes (3)

• Dizziness Handicap Inventory (DHI)

  The Dizziness Handicap Inventory is a validated self-reported questionnaire consisting of 25 items that assess the physical, functional, and emotional impact of dizziness on daily activities. It demonstrates excellent internal consistency (Cronbach's α \> 0.90), strong test-retest reliability, and high responsiveness to clinical change in patients with vestibular disorders, including benign paroxysmal positional vertigo. The DHI is widely regarded as a gold-standard outcome measure for evaluating dizziness-related disability in vestibular rehabilitation research.

  Primary and secondary outcome measures will be assessed at baseline, 4 weeks, and 8 weeks to track changes in motor recovery and functional abilities.

• Berg Balance Scale (BBS)

  The Berg Balance Scale is a widely used clinical assessment tool comprising 14 functional tasks designed to evaluate static and dynamic balance abilities. The BBS demonstrates high inter-rater and intra-rater reliability (ICC = 0.95-0.99) and has been shown to be sensitive in detecting balance impairments and fall risk in individuals with vestibular dysfunction. It is frequently used in both clinical practice and research settings to monitor balance improvements following vestibular rehabilitation.

  Primary and secondary outcome measures will be assessed at baseline, 4 weeks, and 8 weeks to track changes in motor recovery and functional abilities.

• Dynamic Gait Index (DGI)

  The Dynamic Gait Index assesses an individual's ability to modify gait in response to varying task demands, including changes in speed, head movements, and obstacle negotiation. It has demonstrated good reliability and validity in populations with vestibular disorders and is effective in identifying gait instability and fall risk. The DGI is commonly employed to evaluate functional gait improvements following vestibular and balance rehabilitation interventions.

  Primary and secondary outcome measures will be assessed at baseline, 4 weeks, and 8 weeks to track changes in motor recovery and functional abilities.

Study Arms (2)

Group A: Experimental Group (Virtual Reality Assisted Vestibular Rehabilitation)

EXPERIMENTAL

Participants in the VR group will receive supervised VR-based vestibular rehabilitation sessions (VR-Device Controlled) focusing on gaze stabilization, balance training, and functional gait activities using within immersive virtual environments. Each session will last approximately 30 minutes, conducted three times per week for a total duration of four weeks. Immersive VR games such as Verti-Go Home, Beat Saber, balance-based VR simulations, and optic flow tunnel games have been effectively used in vestibular rehabilitation to promote habituation, vestibulo-ocular reflex adaptation, balance control, and patient engagement.

Other: VR (VR-Control)

Group B: Control Group (Conventional Vestibular Rehabilitation)

EXPERIMENTAL

Participants in the conventional therapy group will receive standard vestibular rehabilitation (Brandt-Daroff exercises) consisting of Brandt-Daroff exercises, gaze stabilization exercises, habituation activities, and balance training. The frequency and duration of sessions will be matched to the VR group to ensure comparability.

Other: Conventional Vestibular Rehabilitation

Interventions

VR (VR-Control) OTHER

Participants in the VR group will receive supervised VR-based vestibular rehabilitation sessions (VR-Device Controlled) focusing on gaze stabilization, balance training, and functional gait activities using within immersive virtual environments. Each session will last approximately 30 minutes, conducted three times per week for a total duration of four weeks.

Also known as: VR-Assisted Rehabilitation

Group A: Experimental Group (Virtual Reality Assisted Vestibular Rehabilitation)

Conventional Vestibular Rehabilitation OTHER

Participants in the conventional therapy group will receive standard vestibular rehabilitation consisting of Brandt-Daroff exercises, gaze stabilization exercises, habituation activities, and balance training. The frequency and duration of sessions will be matched to the VR group to ensure comparability

Group B: Control Group (Conventional Vestibular Rehabilitation)

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants of both genders.
• Adults aged 18-40 years.
• Clinically diagnosed with posterior canal Benign Paroxysmal Positional Vertigo (BPPV) confirmed by a positive Dix-Hallpike test, with a duration of at least one month since diagnosis.
• Individuals who have undergone canalith repositioning maneuvers and demonstrate resolution of positional nystagmus.
• Presence of residual dizziness and/or balance impairment persisting after repositioning treatment.
• Ability to ambulate independently and safely participate in balance-related exercises.
• Willingness to participate in the study and provide written informed consent.

You may not qualify if:

• Central vestibular disorders
• Cervical spine instability or severe neck pain
• History of recent head trauma (\<3 months)
• Neurological disorders affecting balance
• Severe visual or cognitive impairment preventing VR use
• Patients of Vertebrobasilar insufficiency (VBI)

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Study Sites (1)

Lahore University of Biological and Applied Sciences

Lahore, Punjab Province, Pakistan

Location

Related Publications (4)

• Ozdil A, Iyigun G, Balci B. Three-dimensional exergaming conjunction with vestibular rehabilitation in individuals with Benign Paroxysmal Positional Vertigo: A feasibility randomized controlled study. Medicine (Baltimore). 2024 Jul 5;103(27):e38739. doi: 10.1097/MD.0000000000038739.

  PMID: 38968532 BACKGROUND

• Lee JW, Yoon CY, Kim JH, Seo YJ, Kong TH. Virtual reality-based vestibular rehabilitation therapy in patients with acute unilateral vestibulopathy: a randomized controlled trial. Front Neurol. 2025 Jan 28;16:1519470. doi: 10.3389/fneur.2025.1519470. eCollection 2025.

  PMID: 39935612 BACKGROUND

• Xie M, Zhou K, Patro N, Chan T, Levin M, Gupta MK, Archibald J. Virtual Reality for Vestibular Rehabilitation: A Systematic Review. Otol Neurotol. 2021 Aug 1;42(7):967-977. doi: 10.1097/MAO.0000000000003155.

  PMID: 33782257 BACKGROUND

• Sana V, Ghous M, Kashif M, Albalwi A, Muneer R, Zia M. Effects of vestibular rehabilitation therapy versus virtual reality on balance, dizziness, and gait in patients with subacute stroke: A randomized controlled trial. Medicine (Baltimore). 2023 Jun 16;102(24):e33203. doi: 10.1097/MD.0000000000033203.

  PMID: 37327306 BACKGROUND

Study Officials

• Nabeela Dawood

  Lahore University of Biological and Applied Sciences

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: This study will use a triple-blind design, where the participants, participants caregivers, outcome assessor and analyst will be blinded and will be unaware of the specific intervention group they have been assigned to (i.e., whether they are receiving the VR-Assisted Vestibular Rehabilitation alone, or Conventional Vestibular Rehabilitation alone). This masking ensures that participant expectations do not influence their responses to the interventions. However, the treating therapists and study coordinators who administer the interventions and assess outcomes will not be masked, as they will be responsible for the direct management of the interventions and data collection. This design allows for an objective evaluation of the effects of the interventions while minimizing potential biases from participant expectations.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 9, 2026
• First Posted: July 14, 2026
• Study Start: May 1, 2026
• Primary Completion: July 30, 2026
• Study Completion (Estimated): September 15, 2026
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)