Sustained Natural Apophyseal Glides With and Without Facilitated Positional Release Technique in Cervicogenic Dizziness
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: SNAGs with FRT, SNAGs.
- Who it may be relevant to
- Registry conditions: Cervicogenic Dizziness. Basic parameters: 18 years — 35 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Pakistan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effects of Sustained Natural Apophyseal Glides With and Without Facilitated Positional Release Technique on Pain, Dizziness, Range of Motion, and Functional Status Among Patients With Cervicogenic Dizziness
Overview
Cervicogenic Dizziness is characterized by non-rotatory dizziness and a sense of disequilibrium associated with neck pain, stiffness, and decreased range of motion. It arises from the abnormal afferent inputs from the upper cervical spine. Patients may experience lightheadedness and neck pain triggered by neck movements, leading to functional limitations. The present study aims to compare the effects of sustained natural apophyseal glides only and in combination with the facilitated positional release technique on pain intensity, severity of dizziness, range of motion, and functional status among patients with cervicogenic dizziness
Detailed description
A double-blinded randomized clinical trial will be conducted at the Government Teaching Hospital, Shahdara, Lahore. A total of 42 patients (21 in each group) will be enrolled in this study, and a non-probability, purposive sampling technique will be used for data collection. Patients will be allocated to Group A and Group B after randomization using an online randomization tool. After obtaining informed consent, Group A will receive treatment of SNAGs along with FPRT, while Group B will receive SNAGs only, three times a week for four weeks. Outcome measures will include the Numeric Pain Rating Scale (NPRS) for pain, the Dizziness Handicap Inventory Scale (DHI) for dizziness, a goniometer for range of motion, and the Neck Disability Index (NDI) for functional status. Assessment will be conducted on the first day and after four weeks of treatment. Data will be analyzed using SPSS version 27. Descriptive statistics will be presented, and the data normality will be assessed using the Shapiro-Wilk test to determine whether a parametric or non-parametric test will be used within or between-group analyses.
Interventions
- Other SNAGs with FRT
SNAG : The therapist will place the palmar aspect of the thumb reinforced by the opposite thumb over the spinous process of C2. The other fingers will apply light pressure on both sides of the face to stabilize the head The therapist will apply anterior glide to C2. Instruct the patient to move his/her neck in the offending direction. FRT: The therapist will palpate the upper trapezius tender point. After palpation, the patient's neck will be brought into a neutral position. The therapist wil - Other SNAGs
The patient will be seated. The therapist will stand behind the patient. The therapist will place the palmar aspect of the thumb reinforced by the opposite thumb over the spinous process of C2. The other fingers will apply light pressure on both sides of the face to stabilize the head The therapist will apply anterior glide to C2. Instruct the patient to move his/her neck in the offending direction.
Primary outcome measures
- Numeric Pain Rating Scale (NPRS) for Pain [Time frame: Upto 4 weeks]
- Dizziness Handicap Inventory Scale (DHI) for dizziness [Time frame: Upto 4 weeks]
- Universal Goniometer for ROM [Time frame: Upto 4 weeks]
- Neck Disability Index (NDI) for disability [Time frame: Upto 4 weeks]
Eligibility criteria
Inclusion criteria
- Age group between 18 and 35 years
- Both male and female participants
- Non-traumatic cervicogenic dizziness with positive cervical torsion test
Exclusion criteria
- • History of cervical trauma or head/face injury
- Vestibular disorder, i.e., BPPV
- Vertebrobasilar Insufficiency
- Positive Dix-Hallpike Maneuver, Alar Ligament Stress Test, and Vertebral Artery Test
- History of cardiovascular disorders
- Pregnancy
- Diagnosed psychological disorders
- History of cervical spine surgery
- Vertebral Fractures
- Spine disorders such as cervical spondylosis and disc herniation
- Presence of tumor
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Pakistan · 1 center
- Government Teaching Hospital Shahdara — Lahore
Publications
- Wrisley DM, Sparto PJ, Whitney SL, Furman JM. Cervicogenic dizziness: a review of diagnosis and treatment. J Orthop Sports Phys Ther. 2000 Dec;30(12):755-66. doi: 10.2519/jospt.2000.30.12.755. PMID 11153554
- Luscher M, Theilgaard S, Edholm B. Prevalence and characteristics of diagnostic groups amongst 1034 patients seen in ENT practices for dizziness. J Laryngol Otol. 2014 Feb;128(2):128-33. doi: 10.1017/S0022215114000188. Epub 2014 Feb 13. PMID 24521903
- Vural M, Karan A, Albayrak Gezer I, Caliskan A, Atar S, Yildiz Aydin F, Coskun Benlidayi I, Goksen A, Koldas Dogan S, Karacan G, Erdem R, Eda Kurt E, Kesiktas FN, Aydin T, Sahin N, Aydin Z, Ordahan B, Turkoglu G, Resorlu H, Doner D, Yilmaz F, Bertan H, Dulgeroglu D, Karaahmet OZ, Sonel Tur B, Moustafa E, Borman P, Iskender O, Ay S, Kurtaran A, Sirzai H, Evcik D, Capan N, Erhan B, Alptekin HK, Ural PMID 35141479
- Bayraklı BB, Kuzu Ö, ÇElİK C. A Rare Cause of Vertigo: Cervicogenic Dizziness. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi. 2025;28:90-2.
- Moen U, Knapstad MK, Wilhelmsen KT, Goplen FK, Nordahl SHG, Berge JE, Natvig B, Meldrum D, Magnussen LH. Musculoskeletal pain patterns and association between dizziness symptoms and pain in patients with long term dizziness - a cross-sectional study. BMC Musculoskelet Disord. 2023 Mar 8;24(1):173. doi: 10.1186/s12891-023-06279-z. PMID 36882720
- Takahashi S. Importance of cervicogenic general dizziness. J Rural Med. 2018 May;13(1):48-56. doi: 10.2185/jrm.2958. Epub 2018 May 29. PMID 29875897
- Sung Y-H. Classification of cervicogenic dizziness. Hearing, Balance and Communication. 2023;21(1):10-5.
- Li Y, Peng B. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician. 2015 Jul-Aug;18(4):E583-95. PMID 26218949
Identifiers
NCT: NCT07646327 · REC/RCR&AHS/25/0122 Aqsa