The effectiveness of manual therapy in treating cervicogenic dizziness: a systematic review

Abstract

[Purpose] This review provides an evaluation of the evidence for the effectiveness of using manual therapy to treat cervicogenic dizziness. [Subjects and Methods] The literature was systematically searched on the May 2, 2016 using the following online databases: Medline, EMBASE, CINAHL and PEDro. This review included randomised controlled trials and compared the efficacy of manual therapy for the treatment of cervicogenic dizziness, compared to other types of intervention. This study measured changes based on dizziness intensity and frequency. [Results] The primary search found 30 articles, but only four articles met the inclusion criteria. Assessment of methodological quality was performed by two researchers using the PEDro scale. The level of evidence was determined using a recognised grading scale. Three out of the four articles were deemed to have high methodological quality, while the fourth was rated as moderate quality. The attributed level of evidence was moderate (level 2). [Conclusion] Manual therapy is potentially effective for managing cervicogenic dizziness. However, due to the heterogeneity of the results and techniques and the low number of studies, further research is recommended to provide conclusive evidence.

Physical therapy interventions for cervicogenic dizziness in a military-aged population: protocol for a systematic review

“…Maitland passive mobilizations and Mulligan SNAGs did not produce a significant difference in intensity of dizziness when compared to placebo after 12 months; however, there was a significant difference in frequency of dizziness and DHI for both passive mobilizations and SNAGs [18]. The systematic reviews by Reid [6] and Yaseen [8] both suggest that there is a need for higher quality evidence to inform the use of manual therapy as a treatment technique for CGD, and Lystad et al [14] recommends further researching manual therapy in conjunction with vestibular rehabilitation as a possible treatment for CGD.…”

“…Cervicogenic dizziness can result in a variety of coexisting symptoms such as unsteadiness, lightheadedness, perceptions of spinning, nausea, and general disorientation [8]. Thompson-Harvey and Hain reported that patients with cervical vertigo have neck pain (94%), true vertigo (27%), and headache (50%) [9].…”

“…Thompson-Harvey and Hain reported that patients with cervical vertigo have neck pain (94%), true vertigo (27%), and headache (50%) [9]. These disabling symptoms may have significant psychological repercussions which can lead to anxiety, depression, and difficulty completing activities of daily living and occupational duties [8]. Patients with both dizziness and neck pain have a lower perceived mental and physical quality of life when compared to patients with dizziness only [10].…”

“…According to a recent systematic review [8], manual therapy is the most common form of treatment for CGD. Several systematic reviews have explored the effects of manual therapy on patients with CGD with several randomized controlled trials having evaluated varying manual techniques, such as sustained natural apophyseal glides (SNAGs) [6,8,14]. According to Reid et al [6], while manual therapy may improve the signs and symptoms of CGD, there is still a need for higher quality evidence.…”

“…Yaseen et al [8] produced the most recent systematic review, with only four studies meeting their inclusion criteria. These studies [15][16][17][18], all of which focused on manual therapy, reported positive outcomes on various measures, such as the Dizziness Handicap Inventory (DHI), visual analog scale (VAS) for dizziness, and frequency of dizziness.…”