Short-term effects of an upper cervical spine traction-manipulation program in patients with cervicogenic dizziness: A case series study

Abstract

BACKGROUND: Damage on the somatosensory system could cause sensation of dizziness, a condition known as cervicogenic dizziness (CD). Manual physical therapy has shown beneficial effects, relieving the symptoms of cervicogenic dizziness. However, the effect of upper cervical spine manipulation is unknown, as this is a technique that respects the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) safety criteria. OBJECTIVE: To assess the effects of upper cervical spine traction-manipulation in subjects with cervicogenic dizziness. METHODS: This was a descriptive case series study. Treatment focused on the upper cervical spine manipulation procedure. Evaluation was performed before and after the treatment. Variables recorded include upper and lower cervical range of motion, Cervical Flexion-Rotation Test (CFRT), dizziness intensity and cervical pain (VAS), self-perceived dizziness measured with Dizziness Handicap Inventory (DHI) and subjective perception of outcome (GROC-scale). RESULTS: Ten subjects were recruited. After the treatment protocol, there was an increased range of movement towards the most restricted side, as measured by the CFRT (p< 0.001), decreased intensity of dizziness (p< 0.001) and intensity of pain (p< 0.001). Functional capacity also improved after the intervention (p< 0.011). CONCLUSION: Upper cervical spine manipulation may decrease dizziness intensity and cervical pain and improve functional ability and upper cervical spine mobility in patients with cervicogenic dizziness.

Effects of the Manual Therapy Approach of Segments C0-1 and C2-3 in the Flexion-Rotation Test in Patients with Chronic Neck Pain: A Randomized Controlled Trial

“…Hidalgo-García et al [3] and Malo-Urriés et al [1] found an increase in the flexion-rotation test when applying a mobilization in C0-1 segment. Carrasco-Uribarren et al [50] evaluated the flexion-rotation test, and applied a protocol of traction manipulation in the resting position in C0-1, C1-2 and C2-3 segments, obtaining similar results to those observed in this study.…”

“…C1-2 rotation is limited by the alar ligament system and occipital, and C2 are the main bony attachments of alar ligaments. Some authors have proposed that C0-1 [1,3] and/or C2-3 [50] dysfunction may inhibit the normal rotational mobility of C1-2 [53]. The MT + E group received a tailored manual therapy treatment according to the C0-1 and C2-3 dysfunction of each patient.…”

“…Manipulation (high-velocity low amplitude) and/or mobilization (low-velocity high amplitude) techniques of C0-1 and C2-3 segments were applied [1,3,48,49] (Figure 2). Manipulations were in the direction of traction, with the head in a neutral position [50]. A maximum of two trials at each level on each side was performed, yielding 2-8 thrusts [51].…”

Comparison of an exercise program with and without manual therapy for patients with chronic neck pain and upper cervical rotation restriction. Randomized controlled trial

“…2Dd ), were combined with cervical exercise in all sessions ( Kaltenborn, 2009 , 2012 ; Krauss & Evjenth, 2009 ; Hidalgo García et al, 2016 ; Malo-Urriés et al, 2017 ). Manipulations were applied in the direction of traction, with the head in a neutral position ( Carrasco-Uribarren et al, 2020 ). A maximum of two trials at each level were performed on each side, yielding 2–6 thrusts per each visit ( Reynolds et al, 2020 ).…”

Effects of Dry Needling of Latent Trigger Points on Viscoelastic and Muscular Contractile Properties: Preliminary Results of a Randomized Within-Participant Clinical Trial

“…These changes would explain the presence of contralateral changes in sensitivity to pressure pain in the current study. However, despite these findings, it seems clear that changes in the treated areas seem to be more substantial than those in distant areas [54][55][56].…”