Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of recurrent vertigo, with a lifetime prevalence of about 2.4% and a yearly incidence of roughly 0.6%. It results from displaced otoconia within the semicircular canals and is especially common in older adults. BPPV leads to brief, position-provoked episodes of vertigo, dizziness, and imbalance, and reduced quality of life. Although canalith-repositioning maneuvers are highly effective, recurrence is common, emphasizing the need for supportive and adjunctive management strategies.This randomized controlled trial will evaluate the Additional Effects OF Brandt-Daroff Exercise With GANS Maneuver On dizziness And Quality of Life In Patients with BPPV. Thirty patients with BPPV will be recruited at Fauji Foundation Hospital and screened using the Dizziness Handicap Inverntory Scale(DHI) and Vestibular Activities and Participation measure(VAP). Participants will be randomized into two groups: (1) Reciving GANS Manuever Alone (2) GANS Manuever with Brandt-Daroff Exercises(3 sessions per week/40minutes). Dizziness will be assessed using the Dizziness Handicap Inverntory Scale(DHI) , quality of life using the Activities and Participation Measure(VAP) Scale. Outcome measures will be recorded at baseline and post-intervention. Ethical approval will be obtained from FUMC ERC, and data will be analyzed using SPSS v.22.
Diagnosed Patients of Benign Paroxysmal Vertigo (BPPV)
Age between 18-60
Acute and Chronic BPPV Patients
Positive Dix-Hallpike Test
Patients with a history of vestibular surgery or cochlear
Patients with a history of seizures or epilepsy
Patients with a pacemaker or implantable cardioverter-defibrillator (ICD)
Patients with a history of severe head injury or concussion within the past year
Parallel
GANS Maneuver with Brandt-Daroff Exercises
Procedure/SurgeryThe intervention program spans six weeks and involves both supervised Gans Maneuver sessions and home-based Brandt-Daroff exercises. Participants will attend two supervised Gans sessions per week, with each session consisting of three repetitions of the maneuver. In addition, participants will perform Brandt-Daroff exercises at home twice daily, with each cycle consisting of three repetitions. This combination of supervised and home-based practice will be maintained consistently throughout all six weeks. Across the entire program, participants will complete a total of 12 supervised Gans sessions and 36 Brandt-Daroff home sessions.
Gans Maneuver
Procedure/SurgeryThe control group will participate in a structured six-week intervention program consisting exclusively of the Gans Maneuver. Participants will attend two supervised sessions per week, ensuring consistent oversight and proper technique throughout the program. Each session will include three repetitions of the maneuver, with participants allowed a rest period of 30 to 60 seconds between repetitions to prevent fatigue and maintain the quality of each movement. This frequency and volume are maintained consistently across all six weeks to provide a standardized exposure, allowing for accurate comparison with other intervention groups. Over the entire six-week period, participants will complete a total of 12 supervised sessions, each with three repetitions, summing up to 36 repetitions across the intervention.
Dizziness
Dizziness Handicap Inventory Scale(DHI): 25 Items (scoring16-54) where 16-34 = Mild handicap , 36-52 = moderate handicap , 52+ = severe handicap
Quality Of Life In BPPV patients
Vestibular Activities and Participation Scale (VAP): A 34-item, (1-4 score) , 1 = mild limitations, 2 = moderate limitation, and 3 = severe limitations, 4=extreme limitation
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