Effectiveness of Brandt-Daroff Exercises in Improving Postural Balance Among Older Adults With Recurrent Vertigo: A Quasi-Experimental Pretest-Posttest Study

Mila Sartika, Riska Subhianti Putri, Risti Tamara Tahanora, Hana Priscilla Frudence Sohilait

Abstract


Introduction: Recurrent vertigo in older adults is frequently associated with impaired postural control, unsteadiness, fear of falling, and reduced independence in daily activities. Brandt-Daroff exercises are a simple home-based vestibular rehabilitation approach that may support balance recovery through repeated positional stimulation and vestibular habituation. However, evidence regarding their use in community-based older adult populations in Indonesia remains limited. Objective: This study aimed to examine the effectiveness of Brandt-Daroff exercises in improving postural balance among older adults with recurrent vertigo. Methods: A quasi-experimental study with a one-group pretest-posttest design was conducted at the Pangudi Luhur Integrated Center, Bekasi, Indonesia. Thirty-three older adults with recurrent vertigo and impaired balance were recruited using total sampling. Postural balance was assessed before and after the intervention using the Romberg Test observation sheet. Participants were taught Brandt-Daroff exercises and performed the exercises three times daily for two consecutive weeks. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Results: Before the intervention, all participants demonstrated impaired postural balance based on the Romberg Test. After two weeks of Brandt-Daroff exercises, 24 participants (72.7%) showed improvement, while 9 participants (27.3%) continued to experience balance impairment. The Wilcoxon signed-rank test indicated a statistically significant improvement in postural balance after the intervention (Z = -4.889, p < 0.001). Conclusion: Brandt-Daroff exercises significantly improved postural balance among older adults with recurrent vertigo. These exercises may serve as a safe, low-cost, and feasible home-based vestibular rehabilitation strategy that can be integrated into community nursing practice. Further studies with control groups, larger samples, validated vertigo-specific outcome measures, and longer follow-up periods are recommended.


Keywords


Brandt–Daroff Exercises; Vertigo; Postural Balance; Aged; Vestibular Diseases

References


Agrawal, Y., Van De Berg, R., Wuyts, F., Walther, L., Magnusson, M., Oh, E., Sharpe, M., & Strupp, M. (2019). Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society. Journal of Vestibular Research: Equilibrium and Orientation, 29(4), 161–170. https://doi.org/10.3233/VES-190672

Anagnostou, E., Gamvroula, A., Kouvli, M., Karagianni, E., Stranjalis, G., Skoularidou, M., & Kalamatianos, T. (2025). A Refined Vestibular Romberg Test to Differentiate Somatosensory from Vestibular-Induced Disequilibrium. 1–13.

Bagri, M., & Joshi, S. (2025). Effect of Transcranial Direct Current Stimulation and Brandt-Daroff Exercises in Benign Paroxysmal Positional Vertigo : A Study Protocol. Meenakshi Bagri, Shabnam Joshi Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India, 63–67. https://doi.org/10.4103/jnsm.jnsm

BKKBN. (2024). Gangguan Keseimbangan dan Risiko Jatuh Pada Lanjut Usia. Kementrian Kependudukan Dan Pembangunan Keluarga/BKKBN. https://doi.org/https://golantang.bkkbn.go.id/mencegah-jatuh-pada-lansia

Chayati, N. (2017). Vertigo: Pencegahan dan Simulasi Deteksi Dini di Pedukuhan Ngrame. 1–15.

Corazzi, V., Ciorba, A., Skarżyński, P. H., Skarżyńska, M. B., Bianchini, C., Stomeo, F., Bellini, T., Pelucchi, S., & Hatzopoulos, S. (2020). Gender differences in audio-vestibular disorders. International Journal of Immunopathology and Pharmacology, 34. https://doi.org/10.1177/2058738420929174

Deaton, M. (2005). An Overview of Online Learning. Technical Communication, 52(2), 224.

Department, A. and H. T. (2024). Brandt-Daroff exercises to treat BPPV. University Hospital Southampton NHS Foundation Trust (UHS), 5.

Dio, K., Bagiartana, A., & Huriah, T. (2023). The Effects Of Core Stability Exercise In Improving Back Muscle Strength, Limb Muscles and Dynamic Balance In The Elderly In Singaraja, Indonesia. Jurnal Keperawatan Soedirman (JKS), 18(2), 58–63. https://doi.org/10.20884/1.jks.2023.18.2.6682

Doewes, R. H. (2017). Hubungan Gangguan Keseimbangan Perifer dan Kualitas Hidup Pasien Lanjut Usia Di RSUD Dr Meowardi Surakarta. Institutional Repository UNS.

Elizabeth, J., Patiño, P., Lluís, J., Moreno, B., Matos, Y. R., Ortega, J. A., Puértolas, O. C., Muñoz, R. C., Balboa, I. V., Compta, X. G., Lucía, O., Agudelo, A., Muñoz, S. C., Rodríguez, V. M., Cortes, A. N., & Rodríguez, E. P. (2022). Correction: Effectiveness of a Training Intervention to Improve the Management of Vertigo in Primary Care: a Multicentre Cluster‑Randomised Trial, VERTAP. Trials, 23, 13063. https://doi.org/10.1186/s13063-022-06759-y

Fancello, V., Hatzopoulos, S., Santopietro, G., Fancello, G., Palma, S., Skarżyński, P. H., Bianchini, C., & Ciorba, A. (2023). Vertigo in the Elderly: A Systematic Literature Review. Journal of Clinical Medicine, 12(6), 1–9. https://doi.org/10.3390/jcm12062182

Fernández, L., Breinbauer, H. A., & Delano, P. H. (2015). Vertigo and dizziness in the elderly. Frontiers in Neurology, 6(JUN), 1–6. https://doi.org/10.3389/fneur.2015.00144

Fitriyani, N. S. F. (2024). An Elderly Woman with Peripher al Vertigo and Trigeminal Neuralgia: Case Report. Medical Profession Journal of Lampung (MEDULA), 14(April), 799–807.

Forbes J, Munakomi S, C. H. (2023). Romberg Test. In: StatPearls [Internet].

Gea, F., Hulu, A. H., & Lase, N. K. (2024). Analisis Sistem Gerak yang Memengaruhi Keseimbangan Tubuh Lansia. Indo-MathEdu Intellectuals Journal, 5(3), 3734–3741. https://doi.org/10.54373/imeij.v5i3.1342

Goto, F., Kaneda, S., & Wasano, K. (2025). Effectiveness of Ryokeijutsukanto in the Treatment of Benign Paroxysmal Positional Vertigo ( BPPV ). Cureus, 17((7): e87161), 5–10. https://doi.org/10.7759/cureus.87161

Hall, C. D., Herdman, S. J., Whitney, S. L., Anson, E. R., Carender, W. J., Hoppes, C. W., Cass, S. P., Christy, J. B., Cohen, H. S., Fife, T. D., Furman, J. M., Shepard, N. T., Clendaniel, R. A., Dishman, J. D., Goebel, J. A., Meldrum, D., Ryan, C., Wallace, R. L., & Woodward, N. J. (2022). Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. In Journal of Neurologic Physical Therapy (Vol. 46, Issue 2). https://doi.org/10.1097/NPT.0000000000000382

Homero, E. C., Luis, O. M., Dehesa-lo, E., & Leo, M. I. C. (2022). Effectiveness of Brandt Daroff , Semont and Epley maneuvers in the treatment of Benign Paroxysmal Positional Vertigo : A Randomized Controlled Clinical Trial. Indian J Otolaryngol Head Neck Surg, 74(3), 314–321. https://doi.org/10.1007/s12070-021-02516-w

Jain PS, Mitra S, D. R. (2021). Comparing Balance among Elderly Fallers and Nonfallers Using Modified Romberg Test : A Case – Control Study. Indian J Community Med, 46, 163–164. https://doi.org/10.4103/ijcm.IJCM

Kumar, A., Kumar, G., & Sharma, G. (2019). Effect of Epley , Semont Maneuvers and Brandt – Daroff Exercise on Quality of Life in Patients with Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo ( PSCBPPV ). Indian Journal of Otolaryngology and Head & Neck Surgery, 71(1), 99–103. https://doi.org/10.1007/s12070-018-1322-7

Luis, J., Moreno, B., Muñoz, R. C., Balboa, I. V., Matos, Y. R., Lucia, O., Agudelo, A., Vasudeva, A., Aguilera, O. B., Ortega, J. A., Guillén, A. C., Johanna, C., Olaya, B., Curto, X. M., Perez, E. R., Ripollès, C. R., Catalina, P., Palacios, S., Farres, N. M., … Ledesma, R. A. (2014). Effectiveness of the Epley’s Maneuver Performed in Primary Care to Treat Posterior Canal Benign Paroxysmal Positional Vertigo: Study Protocol for a Randomized Controlled Trial. Trials Journal, 15, 1–10.

Masruroh, S. H. (2022). Brandt-Daroff Exercise Among Elderly With Vertigo. Innovation in Health for Society, 2(2), 2019–2022. https://doi.org/doi.org/10.31603/ihs.8255

Monoarfa, Susanti., Pipin Yunus., S. K. (2024). Penerapan Terapi Fisik Brandt Daroff Exercises Pada Pasien Untuk Mengatasi Vertigo dan Nyeri Diruang UGD RSUD Prof. DR. H. Aloei Saboe Kota Gorontalo. MANUJU: Malahayati Nursing Journal, 6, 4248–4255. https://doi.org/Doi: https://doi.org/10.33024/mnj.v6i10.15917

Nayarti, H. (2021). Hubungan Postur Terhadap Keseimbangan Tubuh Pada Lansia di Unit Pelaksanaan Daerah Pusat Pelayanan Sosial Lanjut Usia Mappasunggu ParePare. Pharmacognosy Magazine, 75(17), 399–405.

Neuhauser, H. K. (2007). Epidemiology of vertigo. Current Opinion in Neurology, 20(1), 40–46. https://doi.org/10.1097/WCO.0b013e328013f432

Noviana, M., Amany, I., & Pratama, A. D. (2023). Efektivitas Cawthorne Cooksey Exercise dalam Meningkatkan Keseimbangan dan Mengurangi Dizziness Pada Lansia dengan Peripheral Vestibular Disorder. Muhammadiyah Journal of Geriatric, 4(1), 52. https://doi.org/10.24853/mujg.4.1.52-64

Pokhrel, S. (2024). hubungan indeks massa tubuh terhadap keseimbangan lansia pada komunitas. Αγαη, 15(1), 37–48.

Rahmayuli, A. T. (2023). Nursing Care With Brandt Daroff Therapy Intervention Against Acute Pain In Vertigo Patients at Abdul Manap Hospital. Jurnal Keperawatan Universitas Jambi, 8(1), 1–5.

Raksaken, N., Nuntaboot, K., & Information, A. (2024). Qualitative Study To Determine The Meaning of Emergencies Among Elderly People In The Community. Jurnal Keperawatan Soedirman (JKS), 19(3), 180–187. https://doi.org/10.20884/1.jks.2024.19.3.11314

Rohman, A. (2020). Pengaruh Senam Ergonomis Terhadap Keseimbangan Tubuh pada Lansia Di Posyandu Kenanga Kelurahan Sampung, Kecamatan Kawedanan, Kabupaten Magetan.

Sartika, Mila., at all. (2025). Screening Kejadian Vertigo Pada Lansia di Sentra Terpadu Pangudi Luhur Kota Bekasi. Connection: Jurnal Pengabdian Kepada Masyarakat, 5(2), 248–257. https://doi.org/https://doi.org/10.32505/connection.v5i2.12154

Scocco, D. H., & Barreiro, M. A. (2022). Sitting-up Vertigo as an Expression of Posterior Semicircular Canal Heavy Cupula and Posterior Semicircular Canal Short Arm Canalolithiasis. Journal of Otology, 17. https://doi.org/10.1016/j.joto.2022.02.001

Setiawati, M., Kedokteran, F., Lampung, U., Histologi, B., Kedokteran, F., & Lampung, U. (2016). Diagnosis dan Tatalaksana Vertigo. Majority, 5, 91–95.

Shyam Sudhakar S. (2025). Etiological factors and management of vertigo - a retrospective study. Med J Malaysia, 1(Jan;80), 59–64.

Si, N., Liu, M., & Chang, W. (2025). Effect of Different Maneuvers of Repositioning on Benign Paroxysmal Vertigo : a Network Meta ‑ Analysis. BMC Neurology. https://doi.org/10.1186/s12883-025-04123-6

Sivanandam, M., Gour, M. A., & Sneha, B. S. (2019). Romberg ’ s Test versus Kinect © Sense - As Assessment Tool of Static Balance Issues Among Subjects with Type-2 Diabetes. 11.

Smith, P. F., Agrawa, Y., & Darlington, C. L. (2019). Sexual dimorphism in vestibular function and dysfunction. Journal of Neurophysiology, 121(6), 2379–2391. https://doi.org/10.1152/jn.00074.2019

Smith, R. M., Burgess, C., Beattie, J., Newdick, A., Tahtis, V., Sahu, B., Golding, J. F., Marsden, J., & Seemungal, B. M. (2024). Treating Benign Paroxysmal Positional Vertigo in Acute Traumatic Brain Injury : A Prospective , Randomised Clinical Trial Assessing Safety, Feasibility, and Efficacy. BMJ Neurology Open, 1–10. https://doi.org/10.1136/bmjno-2023-000598

Syah, I., & Febriyeni Utami, R. (2021). Aktifitas Fisik Dan Kognitif Berpengaruh Terhadap Keseimbangan Lansia. Human Care Journal, 6(3), 748. https://doi.org/10.32883/hcj.v6i3.1443

Teixido, M., Casserly, R., & Melley, L. E. (2021). Lateral Modified Brandt-Daroff Exercises : A Novel Home Treatment Technique for Horizontal Canal BPPV. The Journal of International Edvanced Otology, 17(1), 52–57. https://doi.org/10.5152/iao.2020.9452

Utama, A. M. T. (2022). Efektivitas Senam Tai Chi Terhadap Keseimbangan Tubuh Pada Lansia. 9, 356–363.

Von Brevern, M., Bertholon, P., Brandt, T., Fife, T., Imai, T., Nuti, D., & Newman-Toker, D. (2015). Benign paroxysmal positional vertigo: Diagnostic criteria. Journal of Vestibular Research: Equilibrium and Orientation, 25(3–4), 105–117. https://doi.org/10.3233/VES-150553

Wassermann, A., Finn, S., & Axer, H. (2022). Age-Associated Characteristics of Patients With Chronic Dizziness and Vertigo. Journal of Geriatric Psychiatry and Neurology, 35(4), 580–585. https://doi.org/10.1177/08919887211036185

Wicaksana, A., & Rachman, T. (2018). Sumabatan Jalan Nafas KDG. Angewandte Chemie International Edition, 6(11), 951–952., 3(1), 10–27. https://medium.com/@arifwicaksanaa/pengertian-use-case-a7e576e1b6bf

Xing, Y., Si, L., Zhang, W., Wang, Y., Li, K., & Yang, X. (2024). Etiologic distribution of dizziness/vertigo in a neurological outpatient clinic according to the criteria of the international classification of vestibular disorders: a single-center study. Journal of Neurology, 271(5), 2446–2457. https://doi.org/10.1007/s00415-023-12166-3

Yuniar, D., Rahayu, S., & Devianti, R. (2024). Fisherman Mobile Screening ( F-Mobile NCDs ) untuk Deteksi Dini Resiko Penyakit Tidak Menular ( PTM ) Berbasis Android pada Nelayan Fisherman Mobile Screening ( F-Mobile NCDs ) for Early Detection of Android-Based Non-Communicable Disease ( NCDs ) Risk in. 16(1). https://doi.org/10.36990/hijp.v16i1.1137




DOI: https://doi.org/10.17509/jpki.v12i1.97367

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Jurnal Pendidikan Keperawatan Indonesia(JPKI) published by Indonesia University of Education. JPKI is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. 

View My Stats

Office :
Nursing Department. FPOK UPI.
229, Dr. Setiabudhi Street. Bandung 40154
West Java , Indonesia
E-mail : [email protected]