Postural and clinical outcomes of sustained natural apophyseal glides treatment in cervicogenic dizziness patients: A randomised controlled trial

Abstract

Objective: To evaluate how self-report and posturographic measures could be affected in patients with cervicogenic dizziness undergoing sustained natural apophyseal glides. Design: Randomised controlled single-blind study. Setting: Tertiary rehabilitation centre. Subjects: Patients affected by cervicogenic dizziness, diagnosed by applying accepted criteria. Forty-one patients (19 male, 22 female: mean age 44.3 ± 14.8 years) receiving treatment, and 39 patients (18 male, 21 female: mean age 43.8 ± 13.9 years) receiving placebo were included in the study. Interventions: The treatment group underwent sustained natural apophyseal glides, while the placebo was constituted by a detuned laser. Both groups received their interventions six times over 4 weeks. Main measures: Outcomes were tested by means of self-report measures such as perceived dizziness, neck disability, anxiety and depression. Also, cervical range of motion and posturography testing with power spectra frequency were analysed. Results: When compared to placebo, treated patients demonstrated a significant decrease in perceived dizziness (post-treatment total Dizziness Handicap Inventory score 20.5 ± 5.3 as compared to 26.2 ± 6 baseline), neck disability and pain (Neck Disability Index and Neck Pain Index post-treatment scores 12.5 ± 4.3 and 45.6 ± 15.1, respectively, as compared to baseline scores of 15.1 ± 4.8 and 62.5 ± 14.3), as well as significant improvement in cervical range of motion and some posturographic parameters. Conclusion: Sustained natural apophyseal glides may represent a useful intervention in reaching short-term beneficial effects in patients with cervicogenic dizziness, with respect to self-perceived symptoms, proprioceptive integration and cervical range of motion improvement.

Proprioceptive Cervicogenic Dizziness: A Narrative Review of Pathogenesis, Diagnosis, and Treatment

“…Up to now, manual therapy has been the most widely studied method for cervicogenic dizziness. Several published prospective randomized controlled studies [ 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 ] and systematic reviews [ 90 , 101 , 102 ] provide evidence to support the use of manual therapy for the treatment of cervicogenic dizziness. Theoretically, a well-integrated vestibulo-cerebellar system can compensate for the change in neck proprioception afferents in the case of cervicogenic dizziness.…”

Subcutaneous stretching enlarges adjacent vertebral artery instantly in patients with cervicogenic dizziness: Two case reports

“…Pharmacological treatment, physical treatment, surgical treatment have shown positive effect on CGD. [16][17][18][19] Among the conservative non-pharmaceutical treatments, physical treatments focus on reducing muscle stiffness and spasms to relieve neck pain and improve dizziness, [17] while acupuncture emphasized on accelerating BFV with an objective outcome measure of average vertebral-basilar artery BFV in improving dizziness. [18] However, increased BFV cannot reflect the blood flow volume when diameter is unknown.…”