Comparative Efficacy of Intensive versus Stepped Vestibular Rehabilitation in Benign Paroxysmal Positional Vertigo: Clinical Trial

Abstract

Objective: To compare the efficacy of intensive versus staggered vestibular rehabilitation in reducing symptoms and improving balance in patients with benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal.

Design/Methodology: Randomized, prospective, two-arm parallel clinical trial conducted in a tertiary general hospital. Patients diagnosed via Dix-Hallpike maneuver were randomly assigned to intensive (n=56) or staggered (n=59) rehabilitation. The primary outcome was improvement on the imbalance scale at 3 weeks.

Results: Among 115 completers (73% female, mean age 50.7 years), 94.8% showed significant improvement, with no between-group differences (p > 0.05). Both approaches reduced severe imbalance from 20.9% to 1.7% within 21 days.

Limitations: Moderate sample size, short-term follow-up, and subjective imbalance assessment.
Originality/Value: This study provides direct comparative evidence between two widely used vestibular rehabilitation protocols not previously contrasted in Mexican population, supporting their flexibility in clinical practice.

Findings/Conclusions: Intensive and staggered vestibular rehabilitation are equally effective in BPPV management. Protocol choice can be individualized based on patient tolerance and preference without compromising outcomes.