Postural and clinical outcomes of sustained natural apophyseal glides treatment in cervicogenic dizziness patients: A randomised controlled trial

Abstract

Objective: To evaluate how self-report and posturographic measures could be affected in patients with cervicogenic dizziness undergoing sustained natural apophyseal glides. Design: Randomised controlled single-blind study. Setting: Tertiary rehabilitation centre. Subjects: Patients affected by cervicogenic dizziness, diagnosed by applying accepted criteria. Forty-one patients (19 male, 22 female: mean age 44.3\u2009±\u200914.8\u2009years) receiving treatment, and 39 patients (18 male, 21 female: mean age 43.8\u2009±\u200913.9\u2009years) receiving placebo were included in the study. Interventions: The treatment group underwent sustained natural apophyseal glides, while the placebo was constituted by a detuned laser. Both groups received their interventions six times over 4\u2009weeks. Main measures: Outcomes were tested by means of self-report measures such as perceived dizziness, neck disability, anxiety and depression. Also, cervical range of motion and posturography testing with power spectra frequency were analysed. Results: When compared to placebo, treated patients demonstrated a significant decrease in perceived dizziness (post-treatment total Dizziness Handicap Inventory score 20.5\u2009±\u20095.3 as compared to 26.2\u2009±\u20096 baseline), neck disability and pain (Neck Disability Index and Neck Pain Index post-treatment scores 12.5\u2009±\u20094.3 and 45.6\u2009±\u200915.1, respectively, as compared to baseline scores of 15.1\u2009±\u20094.8 and 62.5\u2009±\u200914.3), as well as significant improvement in cervical range of motion and some posturographic parameters. Conclusion: Sustained natural apophyseal glides may represent a useful intervention in reaching short-term beneficial effects in patients with cervicogenic dizziness, with respect to self-perceived symptoms, proprioceptive integration and cervical range of motion improvement.