- Title
- The effectiveness of treatment of cervicogenic dizziness with manual therapy
- Creator
- Reid, Susan
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2015
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- The primary aim of this thesis was to determine and compare the effects of two forms of manual therapy on chronic cervicogenic dizziness over the short (12 weeks) and long (12 months) term. Eighty-six participants with chronic cervicogenic dizziness were randomised to receive sustained natural apophyseal glides (SNAGs) with self-SNAGs (n=29), passive joint mobilisations (PJMs) with range of motion (ROM) exercises (n=29), or a placebo intervention (n=28). Participants received 2-6 treatments over 6 weeks, with outcomes measured at baseline, post-treatment, 12 weeks and 12 months. Intention-to-treat analyses were performed, with the significance level set at 0.05. The intensity of dizziness was significantly reduced post-treatment and at 12 weeks in both manual therapy groups, and the frequency of dizziness was significantly reduced at 12 weeks compared to the placebo. The PJM group had less dizziness handicap than the placebo group post-treatment and at 12 weeks, and less pain at 12 weeks. For cervical range of motion (ROM), the SNAG group improved in six directions and the PJM group in one direction post-treatment and at 12 weeks, compared to the placebo group. There was no effect on head repositioning accuracy or balance. When the long-term (12 months) effects of manual therapy were evaluated there were no significant differences in dizziness intensity or pain intensity between the groups, however both manual therapy groups reported dizziness less often and had lower dizziness handicap scores than the placebo group. At 12 months there was greater ROM in six directions for the SNAG group and four directions for the PJM group compared to placebo. There were no meaningful differences between groups for head repositioning accuracy. The SNAG group had better balance than the placebo group on two dynamic tests. There were no differences between the two manual therapy groups at 12 months for any outcomes. Both manual therapy groups found treatment more beneficial than the placebo intervention at 12 weeks and 12 months. There were no adverse effects lasting longer than 24 hours. One limitation of the study was that it was not possible to blind the treating therapist to group allocation. Another limitation was that the effect of the home-based exercises could not be adequately assessed, as compliance with completion of home exercise diaries was poor. As part of this thesis, the process used in this RCT to identify people with cervicogenic dizziness has been outlined as a first step in developing a screening process to identify cervicogenic dizziness in clinical practice. In addition, the physical characteristics of the participants with identified cervicogenic dizziness were compared to normative data to further describe this condition and aide in its identification. Participants with cervicogenic dizziness were found to have significant deficits in cervical ROM, head repositioning accuracy and balance when compared to published normative values. This thesis has provided evidence for the first time that a small number of manual therapy treatments, combined with recommendations to perform simple home-based exercises, can make a significant difference over the short and long term to patients experiencing chronic cervicogenic dizziness. The results have implications in identification and improving treatment for many patients, as dizziness occurring together with neck pain is a common and disabling problem.
- Subject
- dizziness; neck pain; cervical vertebrae; musculoskeletal manipulation; rehabilitation; physiotherapy; randomised controlled trial; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1313649
- Identifier
- uon:22623
- Rights
- Copyright 2015 Susan Reid
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
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| View Details Download | ATTACHMENT01 | Abstract | 495 KB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 10 MB | Adobe Acrobat PDF | View Details Download |