Long-Term Effects of a Multimodal Physiotherapy Program on the Severity of Somatosensory Tinnitus and Identification of Clinical Indicators Predicting Favorable Outcomes of the Program

Abstract

Tinnitus, the perception of sound in the absence of external auditory stimuli, is commonly associated with problems of the auditory system. Head and neck disorders can also be involved in tinnitus emergence. In such cases, the term somatosensory tinnitus is used. Physiotherapy treatments have been identified as a promising avenue in the treatment of somatosensory tinnitus.The aim of the study was to explore the effect of a physiotherapy program on the intensity and severity of somatosensory tinnitus and to identify the clinical characteristics of the patients who respond well to this treatment.Quasi-experimental pre–post single-group design.Thirty-one adults with presumed somatosensory tinnitus.All participants received on average ten physiotherapy treatments over six weeks. Treatments included cervical and thoracic mobilizations, as well as muscular strengthening, stretching, postural instruction, and cervical stabilization.Outcomes were measured at baseline, at the end of the physiotherapy program, and three months later. The primary outcomes were the Tinnitus Handicap Inventory and visual analog scales for loudness and annoyance caused by tinnitus.After the last evaluation, participants were divided into two groups: improved and unimproved participants. Participants were considered improved if they (1) showed significant improvement in at least two of the three primary outcome measures and (2) indicated subjective improvement. Thereafter, the baseline characteristics that correctly identify participants susceptible to improve significantly following treatment were determined (Cohen’s effect size d > 0.8).A significant improvement in tinnitus intensity was observed at the end of the program. Of the 31 participants, 14 experienced persistent improvement in the intensity of their tinnitus and were classified as improved. Baseline characteristics strongly associated with tinnitus improvement were no increase in tinnitus when exposed to noise (d = −1.57), no family history of tinnitus (d = −1.16), somatosensory modulation in response to the contraction used to resist pressure applied to the forehead (d = 1.20), and recent onset of tinnitus (d = 1.03).This exploratory study showed that a multimodal physiotherapy program is effective in decreasing the severity of tinnitus, principally in individuals presenting with somatosensory tinnitus in combination with specific clinical characteristics.

Effect of adding a supervised physical therapy exercise program to photobiomodulation therapy in the treatment of cervicogenic somatosensory tinnitus: A randomized controlled study

“…Treatments included cervical and thoracic mobilizations, as well as muscular strengthening, stretching, postural instruction, and cervical stabilization. [43]…”

“…Treatments included cervical and thoracic mobilizations, as well as muscular strengthening, stretching, postural instruction, and cervical stabilization. [43] Manual therapy appears to be an effective intervention for individuals with somatic tinnitus, especially if they have co-varying tinnitus or tinnitus sensitization. In addition, a multimodal intervention approach may be the ideal way in which to positively impact an individual's activities of daily living.…”

Prevalence of Somatosensory Tinnitus in Veterans With Tinnitus

“…Although a limited number of research studies have been done investigating the benefit of physiotherapy for ST, the published research is promising (Sanchez & Rocha 2011; Cherian et al 2013; Michiels et al 2016, 2017, 2018, Cote et al 2019). When ST is associated with dysfunction in the temporomandibular area, orofacial physical therapy has been shown to improve symptoms (Kinne et al 2019, Van der Wal et al 2020) and sometimes resolve the tinnitus completely (Ralli et al 2017).…”

Somatosensory Stimulation Therapy in Patients with Somatosensory Tinnitus: A Pilot Study

“…The sample size calculation was based on data of the THI obtained from a previous study (48.2 ± 22.7 at baseline, 32.7 ± 22.7 at 1-wk postintervention, and 33.6 ± 21.9 at 12 wk) (18) and using StatMate 2.0 (GraphPad Software Inc., San Diego, CA). The sample size was calculated for 80% power to reject the null hypothesis and a type I error of 0.05.…”