Effects of Cervical Spine Manual Therapy on Range of Motion, Head Repositioning, and Balance in Participants With Cervicogenic Dizziness: A Randomized Controlled Trial

Reid, Susan A.; Callister, Robin; Katekar, Michael G.; Rivett, Darren A.

doi:10.1016/j.apmr.2014.04.009

Cited by 79 publications

(62 citation statements)

References 34 publications

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“…123 Similarly, in a study of individuals with cervicogenic dizziness, while dizziness improved with manual therapy, changes in JPS and balance were negligible. 85,86 These findings suggest that additional interventions directed toward these specific other impairments may need to be considered.…”

Section: Cervical Musculoskeletal Managementmentioning

confidence: 99%

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

Treleaven¹

2017

Journal of Orthopaedic & Sports Physical Therapy

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Synopsis There is considerable evidence to support the importance of cervical afferent dysfunction in the development of dizziness, unsteadiness, visual disturbances, altered balance, and altered eye and head movement control following neck trauma, especially in those with persistent symptoms. However, there are other possible causes for these symptoms, and secondary adaptive changes should also be considered in differential diagnosis. Understanding the nature of these symptoms and differential diagnosis of their potential origin is important for rehabilitation. In addition to symptoms, the evaluation of potential impairments (altered cervical joint position and movement sense, static and dynamic balance, and ocular mobility and coordination) should become an essential part of the routine assessment of those with traumatic neck pain, including those with concomitant injuries such as concussion and vestibular or visual pathology or deficits. Once adequately assessed, appropriate tailored management should be implemented. Research to further assist differential diagnosis and to understand the most important contributing factors associated with abnormal cervical afferent input and subsequent disturbances to the sensorimotor control system, as well as the most efficacious management of such symptoms and impairments, is important for the future. J Orthop Sports Phys Ther 2017;47(7):492–502. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7052

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Section: Cervical Musculoskeletal Managementmentioning

confidence: 99%

Dizziness, Unsteadiness, Visual Disturbances, and Sensorimotor Control in Traumatic Neck Pain

Treleaven¹

2017

Journal of Orthopaedic & Sports Physical Therapy

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“…48 Approximately 47% of the global population experience cervicogenic headaches. 49 Cervicogenic dizziness is triggered by cervical movements or positions 50 and occurs because of changes in afferent signals from the cervical spine, resulting in disequilibrium and changes in spatial orientation, without vestibular involvement. 51 Such dizziness often results from flexion-extension injuries including whiplash, but is also seen in those with cervical herniated intervertebral discs, arthritis, head trauma, and cervical muscle spasms as well as other forms of cervical spine dysfunction.…”

Section: Cervicogenic Dizziness and Headachementioning

confidence: 99%

Cervical Spine Manual Therapy for Aging and Older Adults

Tudini

Chui

Grimes

et al. 2016

Topics in Geriatric Rehabilitation

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Neck pain is a common problem in aging and older adults. This narrative review synthesizes recent literature on manual therapy to the cervical spine and adjacent regions. Emphasis has been placed on summarizing high-quality randomized clinical trials, systematic reviews with a narrative synthesis or meta-analysis, and clinical practice guidelines. The synthesis suggests that although there is limited high-quality evidence, a multimodal approach including manual therapy and exercise seems safe and effective, especially in the short term, for improving outcomes in aging and older adults with neck pain. The results for cervicogenic dizziness and headache were too varied to arrive at a firm conclusion. Additional research using consistent outcome measures is needed to establish the optimal manual therapy techniques and parameters for these common cervical conditions. , PT, DPT, MS, OCS, ATC 20% of individuals 70 years of age and older experience neck pain at least one time per month. 11 Within this population, neck pain is associated with other health complaints and poorer self-rated health. 12 Physical therapy is one of the first treatment options for patients with mechanical, insidious neck pain, often with manual therapy as the preferred approach. 13 This is especially true in the elderly population where pain medication must be used cautiously because of the risk of drug interactions and associated comorbidities. 14 For this review, neck pain is classified into 4 categories: chronic nonspecific neck pain, cervical radiculopathy, cervicogenic dizziness and headache, and acute and subacute neck pain including whiplash.Although beyond the scope of this article, there are several useful reviews on pathophysiology, imaging, and conservative and surgical management of cervical spine pathology. 15-18 What follows is a synthesis of recent literature on manual therapy to the cervical spine for 4 common classifications of neck pain. Emphasis has been placed on summarizing high-quality randomized clinical trials, systematic reviews with a narrative synthesis or meta-analysis, and clinical practice guidelines. CHRONIC NONSPECIFIC NECK PAINNonspecific neck pain is defined as cervical pain without pathogenic and/or pathognomonic signs and symptoms. 13 When serious pathology and specific diseases have been excluded, the anatomical source of symptoms is difficult to establish. 19 Thus, this type of pain has also been named cervical pain of unknown origin. 20 Other popular names include the cervical syndrome, which refers to a set of disorders caused by changes in the cervical spine and the soft tissue surrounding it, with pain as the predominant symptom, 21 or chronic mechanical neck pain. Chronic nonspecific neck pain is very common, affecting up to 46% to 54% of the population. 22 It is also described as a significant predictor of sickness absence. 23 SafetyAn analytical review of orthopedic manual therapy including manipulation, specifically to the cervical spine and in an older population, should be preceded by a discussion ...

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“…Mean-while, the heat treatment affection of the laser on the disc and its surrounding tissue can dilate blood vessels, reduce algogenic substance, and normalize the func-tion of the autonomic nervous system, all of which can release the inflammation in the discsurrounding nerve tissue or increase the irritability threshold of the sympathetic nervous system thus improving the vertebralbasilar arterial blood supply (92). In a recent study by Li et al (94), 31 patients who were diagnosed as cervical spondylosis with sympathetic symptoms underwent anterior cervical fusion with PLL resection and were followed up for ≥ 5 years. At the final follow-up, good to excellent results were attained in 80.6% of these patients and the mean 20-point score decreased significantly from 7.3 ± 3.5 before surgery to 2.2 ± 2.7 (P < 0.001).…”

Section: Treatmentmentioning

confidence: 99%

“…At the final follow-up, good to excellent results were attained in 80.6% of these patients and the mean 20-point score decreased significantly from 7.3 ± 3.5 before surgery to 2.2 ± 2.7 (P < 0.001). They assumed that when these sympathetic nerves were excited, a sympathetic reflex was induced, which passed through the sympathetic reflex center located in the thoracic spinal cord and passing out into postganglionic sympathetic fibers innervated around the target organs including the vertebral artery, heart, and eyes etc., leading to sym-pathetic symptoms including vertigo, headache, blurry vision, and palpitation (94). Sympathetic nerve fibers distributed around the vertebral artery have been implicated in the autoregulation of vertebrobasilar artery (VBA) blood flow and CBF.…”

Section: Treatmentmentioning

confidence: 99%