Vertigo Coach© application as an adjunct to canalith repositioning techniques to improve dizziness, vertigo severity, and quality of life in patients with posterior canal benign paroxysmal positional vertigo: a randomized controlled trial protocol.

backgroundBenign paroxysmal positional vertigo (BPPV), particularly involving the posterior semicircular canal (PC-BPPV), is the most common peripheral vestibular disorder, characterized by brief episodes of vertigo triggered by positional changes. It affects quality of life, increases fall risk, and restricts daily and occupational activities. Vestibular rehabilitation therapy (VRT) is an exercise-based approach that is commonly used in clinical management. Mobile health-based formats represent a delivery option for vestibular rehabilitation in the management of PC-BPPV, through structured, user-accessible applications such as the Vertigo Coach. The application integrates habituation, gaze stabilization, and balance exercises with progress tracking and educational content and functions as a structured adjunct to canalith repositioning techniques for presenting exercises and documenting usage. Although preliminary studies indicate feasibility, high-quality evidence from randomized controlled trials evaluating smartphone-based vestibular rehabilitation remains limited.

objectiveTo evaluate the effects of smartphone-based habituation exercises compared with conventional booklet-based exercises, when combined with CRTs, on dizziness, vertigo severity, and quality of life in individuals with PC-BPPV.

methodsA single-blind, two-arm parallel-group randomized controlled trial will be conducted with 84 participants aged 18-65 years diagnosed with PC-BPPV. Participants will be randomized into two groups: Group A (n = 43) will receive a printed instructional booklet, and Group B (n = 43) will use the Vertigo Coach smartphone application. Both groups will receive standardized CRTs. A 6-week VRT program will be delivered in the assigned format, with assessments at baseline, 3 weeks, and 6 weeks. Primary outcomes include dizziness severity, vertigo-related disability, and quality of life, measured using validated tools. DISCUSSION: Mobile health-based formats may provide an alternative method for delivering vestibular rehabilitation in the management of PC-BPPV. This trial will examine whether app-based VRT produces comparable or differential effects relative to booklet-based home programs when administered with CRTs. The findings may inform the use of digital formats for vestibular rehabilitation by providing data on feasibility, symptom change, and user-reported outcomes. Such approaches may offer structured home-based exercise information and facilitate access to rehabilitation resources. ETHICS AND DISSEMINATION: The trial has been reviewed and approved by the Institutional Ethics Committee (reference no. DMIHER (DU)/IEC/2025/628). TRIAL REGISTRATION NUMBER: CTRI/2025/03/083581. Registered on April 2nd 2025.