An upper cervical spine treatment protocol for cervicogenic dizziness: a randomized controlled trial

Physiother Theory Pract. 2022 Nov;38(13):2640-2649. doi: 10.1080/09593985.2021.1972500. Epub 2021 Sep 8.

Abstract

Introduction: Physiotherapy is a common treatment used for cervicogenic dizziness (CD). Treatment of the cervical spine using manual therapy techniques shows moderate evidence in favor of its use. International criteria for the treatment of the cervical spine have been described. Detecting patients' contraindications is the most important safety consideration. International criteria and recommendations for treatment of the cervical spine have been described, as well as safety criteria. A safe traction-manipulation intervention protocol is therefore possible. However, the effects of this protocol on dizziness intensity and dizziness-related disability have not been studied.

Objective: To analyze the effects of a traction-manipulation protocol in patients with CD.

Methods: The patients were referred by an otoneurologist, and after inclusion were randomly divided into a control group and an intervention group. The intervention was based on the application of a traction-manipulation protocol in the resting position. Dizziness intensity, self-reported disability, and cervical range of motion with and without a fixed gaze were assessed. All data were collected beforehand and at two days and four weeks after intervention.

Results: At the two-days follow-up, statistically significant differences in favor of the intervention were observed between groups in the primary outcomes of dizziness intensity (p < .001) and Dizziness Handicap Inventory (p < .001), and at the four-week follow-up in dizziness intensity (p < .001) and Dizziness Handicap Inventory (p < .001).

Conclusions: The traction-manipulation protocol reduces the intensity of dizziness, the patient's self-perceived disability, and improves cervical mobility with and without fixed gaze.

Keywords: Dizziness; disability; musculoskeletal manipulations; neck; spine.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Cervical Vertebrae
  • Clinical Protocols
  • Dizziness* / etiology
  • Dizziness* / therapy
  • Humans
  • Manipulation, Spinal* / methods
  • Neck Pain / therapy
  • Randomized Controlled Trials as Topic
  • Range of Motion, Articular
  • Treatment Outcome
  • Vertigo