Sustained Natural Apophyseal Glides With and Without Facilitated Positional Release Technique in Cervicogenic Dizziness

Официальное название

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

Обзор

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

Подробное описание

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.

Вмешательства

• Другое 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
• Другое 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.

Первичные конечные точки

• Numeric Pain Rating Scale (NPRS) for Pain [Срок оценки: Upto 4 weeks]
• Dizziness Handicap Inventory Scale (DHI) for dizziness [Срок оценки: Upto 4 weeks]
• Universal Goniometer for ROM [Срок оценки: Upto 4 weeks]
• Neck Disability Index (NDI) for disability [Срок оценки: Upto 4 weeks]

Критерии участия

Критерии включения

• Age group between 18 and 35 years
• Both male and female participants
• Non-traumatic cervicogenic dizziness with positive cervical torsion test

Критерии исключения

• • 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

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Пакистан · 1 центр

• Government Teaching Hospital Shahdara — Lahore

Публикации

• 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

Идентификаторы

NCT: NCT07646327 · REC/RCR&AHS/25/0122 Aqsa

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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