Cervicogenic dizziness. The effect of manual therapy and deep neck flexor training

Background and purpose Cervicogenic dizziness is a feeling of disequilibrium caused by disturbed sensory input from the proprioceptors of the neck. Manual therapy is a common treatment for cervicogenic dizziness. Deep neck flexor training has been indicated to be an effective treatment in reducing dizziness. The purpose of this study was to explore the efficacy of manual therapy in conjunction with deep neck flexor training on cervicogenic dizziness. Method Single subject experimental withdrawal design (A-B-A) was used. One patient was included. The intervention consisted of manual therapy and training of the deep neck flexors. The primary outcome measure, intensity of dizziness was measured with a Visual Analog Scale. The intensity of neck pain was measured with a Numeric Pain Rating Scale. The impact of dizziness on daily life was evaluated by the Dizziness Handicap Inventory. Active cervical range of motion was measured with a cervical goniometer and a pressure sensor was used to estimate the activity and endurance of the deep neck flexors. Results There was a tendency for the intensity of dizziness and self-perceived disability due to dizziness to decrease at the end of the treatment period. The treatment did not have a clinical effect on neck pain, active cervical range of motion or on the activity and endurance of the deep neck flexor muscles. It was difficult to interpret the results due to an unstable baseline. Conclusion The results indicate that manual therapy may be an effective treatment in reducing intensity of dizziness and self-perceived disability due to dizziness. These results are in accordance with previous studies. Due to the study's low internal and external validity more research is needed before concluding on the effects of this treatment on cervicogenic dizziness