Abstract
Objective
To evaluate and compare the effects of 2 manual therapy interventions on cervical
spine range of motion (ROM), head repositioning accuracy, and balance in patients
with chronic cervicogenic dizziness.
Design
Randomized controlled trial with 12-week follow-up using blinded outcome assessment.
Setting
University School of Health Sciences.
Participants
Participants (N=86; mean age ± SD, 62.0±12.7y; 50% women) with chronic cervicogenic
dizziness.
Interventions
Participants were randomly assigned to 1 of 3 groups: sustained natural apophyseal
glides (SNAGs) with self-SNAG exercises, passive joint mobilization (PJM) with ROM
exercises, or a placebo. Participants each received 2 to 6 treatments over 6 weeks.
Main Outcome Measures
Cervical ROM, head repositioning accuracy, and balance.
Results
SNAG therapy resulted in improved (P≤.05) cervical spine ROM in all 6 physiological cervical spine movement directions
immediately posttreatment and at 12 weeks. Treatment with PJM resulted in improvement
in 1 of the 6 cervical movement directions posttreatment and 1 movement direction
at 12 weeks. There was a greater improvement (P<.01) after SNAGs than PJM in extension (mean difference, −7.5°; 95% confidence interval
[CI], −13° to −2.0°) and right rotation (mean difference, −6.8°; 95% CI, −11.5° to
−2.1°) posttreatment. Manual therapy had no effect on balance or head repositioning
accuracy.
Conclusions
SNAG treatment improved cervical ROM, and the effects were maintained for 12 weeks
after treatment. PJM had very limited impact on cervical ROM. There was no conclusive
effect of SNAGs or PJMs on joint repositioning accuracy or balance in people with
cervicogenic dizziness.
Keywords
List of abbreviations:
CI (confidence interval), CROM (Cervical Range of Motion), NHP (neutral head position), PJM (passive joint mobilization), ROM (range of motion), SNAG (sustained natural apophyseal glide)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 01, 2014
Footnotes
Supported by a Mulligan Concept Teachers Association Research Award.
Australian New Zealand Clinical Trials Registry No.: ACTRN12611000073909.
Disclosures: none.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
