Effect of Auditory Exercises on postural control and co-ordination among individuals with Benign Paroxysmal Positional Vertigo:- A case series

Background Benign Paroxysmal Positional Vertigo (BPPV) is characterized by brief episodes of vertigo triggered by head movements and is commonly associated with impairments in postural control and coordination. Although canalith repositioning maneuvers(CRM) are the primary treatment, residual balance deficits may persist, highlighting the need for adjunct rehabilitation strategies. Auditory-based exercises may facilitate multi-sensoryintegration and enhance balance control; however, evidence supporting their role in BPPV rehabilitation remains limited. This case series aimed to estimate the impact of a structured auditory exercise program on postural control and coordination in individuals with BPPV. Case presentation Five individuals aged 20–50 years diagnosed withright or left posterior canal BPPV were included in this case series. All participants initially underwent standard canalith repositioning maneuvers (CRM), followed by a four-week auditory training program consisting of auditory attention tasks, spatial sound localization exercises, and dual-task auditory–motor coordination activities (30 minutes per day, five days per week). Outcome measures assessed pre- and post-intervention included the Mini-Balance Evaluation Systems Test (Mini-BESTest) for dynamic postural control, the Visual Vertigo Analogue Scale (VVAS) for visual-induced dizziness, the Dizziness Handicap Inventory (DHI) for dizziness-related functional limitations, and the Tandem Gait Test for gait coordination. Post-intervention assessments demonstrated consistent improvements across all outcomes. Mean Mini-BESTest scores increased from 15.8 (median 16) to 21.4 (median 20), VVAS scores decreased from mean 74.4 (median 73) to 61 (median 61), DHI scores decreased from mean 56.8 (median 54) to 31.6 (median 30), and tandem gait steps increased from mean 6.8 (median 6) to 11.4 (median 11). Conclusion This case series indicates that auditory-based exercises, when combined with standard canalith repositioning maneuvers, may positively influence postural control, reduce dizziness-related symptoms, and improve gait coordination in individuals with BPPV. These findings suggest a potential role for auditory exercises as a complementary intervention within vestibular rehabilitation programs aimed at enhancing balance and coordination outcomes in this population.