Cervicogenic somatosensory tinnitus: An indication for manual therapy plus education? Part 2: A pilot study

Rob A B Oostendorp; Iem Bakker; Hans Elvers; Emilia Mikolajewska; Sarah Michiels; Willem De Hertogh; Han Samwel

doi:10.1016/j.math.2016.02.006

Cervicogenic somatosensory tinnitus: An indication for manual therapy plus education? Part 2: A pilot study

Man Ther. 2016 Jun:23:106-13. doi: 10.1016/j.math.2016.02.006. Epub 2016 Feb 21.

Authors

Rob A B Oostendorp¹, Iem Bakker², Hans Elvers³, Emilia Mikolajewska⁴, Sarah Michiels⁵, Willem De Hertogh⁶, Han Samwel⁷

Affiliations

¹ Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Pain in Motion International Research Group(1), Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: rob.oostendorp@planet.nl.
² Practice for Manual Therapy, Arnhem, The Netherlands.
³ Department of Public Health and Research, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute for Methodology and Statistics Beuningen, Beuningen, The Netherlands.
⁴ Department of Physiotherapy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland; Rehabilitation Clinic, Military Clinical Hospital No. 10 with Polyclinic, Bydgoszcz, Poland; Neurocognitive Laboratory, Center for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń, Poland.
⁵ Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology, Antwerp University Hospital, Antwerp, Belgium.
⁶ Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
⁷ Department Medical Psychology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.

PMID: 26971019
DOI: 10.1016/j.math.2016.02.006

Abstract

Objectives: The aim of this study was to evaluate the efficacy of Manual Therapy Utrecht (MTU) plus education in patients with cervicogenic somatosensory tinnitus (CeT).

Study design: Pretest-posttest design.

Method: Five hundred and six patients were referred or referred themselves. A subgroup of patients was identified with CeT, and within this a subgroup with tinnitus sensitization (TS). Two CeT groups were created based on the presence or absence of TS. Both groups underwent manual therapy combined with tinnitus education. Tinnitus intensity (VAS-tin 0-100 mm) was the primary outcome measure. Number of treatments and adverse effects were the secondary outcome measures.

Results: A total of 122 patients with CeT (24.1%) were included (average age 53.3 years [±9.8], female 38.5% and duration of tinnitus 7.3 years [±8.9]). Patients were divided into two groups: 55 patients (45.1%) with TS (CeT + TS group) and 67 patients (54.9%) without TS (CeT - TS group). Pretest to posttest differences on the VAS-tin were statistically significant within both groups (CeT - TS group: difference VAS-tin 5.9 [p = 0.01]; CeT + TS group: difference VAS-tin 18.2 [p = 0.00]), and between the groups in favor of the CeT + TS group (difference VAS-tin 12.3 [p = 0.01]). Pretest to posttest differences were clinically significant for the CeT + TS group (difference VAS-tin 18.2 [MCIC = ≥10 mm VAS-tin]) and between the groups (difference VAS-tin 12.3 in favor of the CeT + TS group). The average number of treatment sessions was 9.6 (±2.6) for the CeT - TS group and 10.3 (±2.5) for the CeT + TS group, a non-significant difference. There were no adverse effects in either group.

Conclusions: Despite its limitations, this study provides valuable information on both the characteristics of patients with CeT and TS in a Dutch primary care manual therapy practice and on the potential effectiveness of MTU combined with tinnitus education for the subgroup of CeT + TS patients.

Keywords: Cervical spine; Education; Manual therapy; Outcome; Somatosensory tinnitus; Tinnitus sensitization.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Aged, 80 and over
Cervical Vertebrae / physiopathology*
Female
Humans
Male
Middle Aged
Musculoskeletal Manipulations / education*
Netherlands
Patient Education as Topic*
Pilot Projects
Surveys and Questionnaires
Tinnitus / diagnosis*
Tinnitus / therapy*
Treatment Outcome