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Abstract Background Neurological conditions including stroke, Parkinson's disease, multiple sclerosis and traumatic brain injury significantly compromise functional independence and quality of life. Traditional rehabilitation approaches while evidence based frequently encounter barriers to sustained patient engagement and long term adherence. Dance based interventions have emerged as promising culturally adapted therapeutic modalities that may enhance rehabilitation outcomes through multisensory stimulation, rhythmic priming and psychosocial benefits. Garba a traditional Indian folk dance form offers a culturally meaningful vehicle for neurorehabilitation through its integrated combinations of rhythmic movement, bilateral coordination training, dynamic balance challenges and inherent social engagement. Objective This pilot study evaluated the effectiveness of four week Chair Garba Rhythm Therapy as an adjunct to standard neurological rehabilitation on balance performance, functional mobility and quality of life in adults with diverse neurological conditions. Methods A pre post pilot study with a control group was conducted at a tertiary care rehabilitation facility in Pimpri, India. Twenty two adults with confirmed neurological diagnoses (stroke n = 10, Parkinson's disease n = 8, multiple sclerosis n = 2, traumatic brain injury n = 2) were enrolled. The intervention group (n = 22) received 16 sessions of structured Chair Garba Rhythm Therapy over four weeks (four sessions weekly 45 minutes per session) in addition to standard physiotherapy. All participants completed standardized assessments at baseline and week four. Primary outcomes included balance performance measured by the Mini Balance Evaluation Systems Test (Mini BESTest) and quality of life assessed via the World Health Organization Quality of Life BREF (WHOQOL BREF). Secondary outcomes included functional mobility measured by the Timed Up and Go Test (TUG). Statistical analysis employed paired t tests with effect size calculation using Cohen's d value. Results Substantial improvements were observed across all primary and secondary outcomes. Mini BESTest scores increased significantly by 6.4 ± 3.2 points (95% confidence interval 4.98–7.82 t₂₁=9.38, p
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