Effects of Cervical and Oculomotor Exercises in Young Adults With Benign Paroxysmal Positional Vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common type of dizziness disorder in the community.Its cardinal symptoms include vertigo which is induced by change in position of head, turning over in bed, looking up, lying down in bed or any sudden change in the position of head. This study compares the effectiveness of occulomotor exercises alone and combined cervical and occulomotor exercises which take 6 weeks to implement and recruit results and each session lasting 10-20 minute Assessment will be performed at baseline.

Study Overview

• Status: Completed
• Conditions: Dizziness; Nystagmus
• Intervention / Treatment: Procedure: Cervical Exercises; Procedure: Occulomotor exercises

Detailed Description

Benign Paroxysmal Positional Vertigo (BPPV) is the most prevalent peripheral vestibular disorder, significantly affecting patients' daily activities and quality of life. While vestibular maneuvers are widely used for treatment, evidence on the added benefits of combining these maneuvers with therapeutic exercises remains limited. This study aims to fill that gap by evaluating the effectiveness of an integrated approach, potentially enhancing symptom relief and supporting evidence-based clinical decisions. The combination may offer a more holistic strategy for managing BPPV, guiding healthcare professionals toward improved treatment protocols. Additionally, the research emphasizes a quick, accessible intervention suitable for clinical and emergency settings. By reducing dizziness more effectively, the study aspires to improve functional outcomes for patients. Overall, it highlights the value of innovative, combined therapies in vestibular care.

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Islamabad, Pakistan, 44000
    • Foundation University College of Physical Therapy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosed Patients of Benign Paroxysmal Vertigo (BPPV)
• Age between 18-35 years
• Male & Female Patients
• Positive Dix-Hall pike Test
• Normal Cognitive Function: Able to follow instructions and provide informed consent.
• Normal or Corrected-to-normal Vision
• DHI Scale: Moderate (0-100)

Exclusion Criteria:

• Patients with visual impairment
• Pregnancy
• Patients with a history of severe heart disease
• Patients with a pacemaker or implantable cardioverter-defibrillator (ICD)
• No other vestibular disorders or conditions that may affect balance
• Pre-Existing Neurological or Musculoskeletal Conditions

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cervical exercises; Week 1: DNF Strengthening (basic chin tuck) + Smooth Pursuit + Basic Saccades Week 2: DNF Progression (longer hold) + Saccadic Eye Movement + Smooth Pursuit Week 3: Adaptation X1 (with head movement) Week 4: DNF with Arm Movements + Adaptation X2 (slow head & target) Week 5: Saccades with Head Movements Week 6: DNF	Procedure: Cervical Exercises; Cervical exercise include Deep Neck flexor strengthening starts with the patient lie supine with knees bent. Perform chin tuck and lift head ~2-3 cm off the surface. Hold for 5- 10 seconds. 10 repetitions, 2 sets daily. DNF activate stabilizing neck muscles and reduce Cervicogenic Input & provides quick, non-invasive relief from BPPV.
Experimental: Occulomotor exercises; Week 1: Smooth Pursuit + Basic Saccades Week 2: Saccadic Eye Movement + Adaptation X1 (slow speed) Week 3: Adaptation X1 (moderate speed) + Smooth Pursuit (increased range) Week 4: Adaptation X2 (slow) + Complex Saccades (with distractions) Week 5: Adaptation X2 (faster) + Smooth Pursuit (large range) Week 6: All Oculomotor Exercises in Circuit (Saccades + Pursuit + X1 + X2)	Procedure: Occulomotor exercises; Oculomotor exercises are used to treat BPPV and involve repeated head movements to habituate the brain to vertigo triggers. Saccadic Eye Movement Exercises: Moving the eyes quickly between two stationary targets while keeping the head still. Smooth Pursuit Exercises: Tracking a moving target with the eyes while keeping the head stationary. Adaptation X1 Exercises: Moving the head horizontally while maintaining focus on a stationary target. Adaptation X2 Exercises: Simultaneously moving the head and target in opposite directions horizontally, requiring the eyes to track the moving target.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nystagmus	Dynamic leap and balance test Moderate Impairment: Noticeable instability, excessive sway, needs extra steps to regain balance, and slower performance. Severe Impairment: Unable to maintain balance after landing, requires assistance, or is unable to complete the task safely.	6 weeks
benign paroxysmal positional vertigo	Dix-Hall pike Test (DHT) is considered the gold standard assessment for the diagnosis of the vestibular disorder benign paroxysmal positional vertigo (BPPV). The patient starts in a sitting position and their head is turned 45° towards the side to be tested. The assessor then assists them to lie down quickly and extends their neck 20° over the end of the plinth, maintaining 45° rotation. The assessor should be able to see the patient's eyes and should observe for nystagmus. A positive response is elicited if rotational nystagmus is noted. The nystagmus will have a delayed onset of approximately 1-2 seconds following movement and it should subside after 10-20 seconds	6 weeks
Dizziiness	The Dizziness Handicap Inventory (DHI) is a widely used tool to assess the impact of dizziness on an individual's daily life.The total score ranges from 0 to 100, with higher scores indicating a greater impact of dizziness.	6 weeks

Collaborators and Investigators

• Sponsor: Foundation University Islamabad

Study record dates

Study Major Dates

• Study Start (Actual): February 20, 2026
• Primary Completion (Actual): April 25, 2026
• Study Completion (Actual): May 1, 2026

Study Registration Dates

• First Submitted: May 8, 2026
• First Submitted That Met QC Criteria: May 8, 2026
• First Posted (Actual): May 14, 2026

Study Record Updates

• Last Update Posted (Actual): May 14, 2026
• Last Update Submitted That Met QC Criteria: May 8, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Benign Paroxysmal Positional Vertigo; Dynamic Balance; Oculomotor Exercise; Dynamic Leap and Balance Test; Cervical Exercises
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Eye Diseases; Otorhinolaryngologic Diseases; Sensation Disorders; Ear Diseases; Cranial Nerve Diseases; Ocular Motility Disorders; Labyrinth Diseases; Vestibular Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Vertigo; Benign Paroxysmal Positional Vertigo; Dizziness; Nystagmus, Pathologic
• Other Study ID Numbers: FUI/FUCP/CTR/Neuro/Anosha

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No