OBJECTIVE: To evaluate and compare the effects of two manual therapy interventions on cervical spine range of motion (ROM), head repositioning accuracy and balance, in patients with chronic cervicogenic dizziness. DESIGN: Randomized controlled trial with 12-week follow-up using blinded outcome assessment. SETTING: University in New South Wales, Australia. PARTICIPANTS: Participants (n = 86; mean +/- SD age 62.0 +/- 12.7 years; 50% women) with chronic cervicogenic dizziness. INTERVENTIONS: Participants were randomly assigned to one of three groups: sustained natural apophyseal glides (SNAGs) with self-SNAG exercises, passive joint mobilization (PJM) with ROM exercises, or a placebo. Participants each received 2 to 6 treatments over six weeks. MAIN OUTCOME MEASURES: Cervical ROM, head repositioning accuracy, and balance. RESULTS: SNAG therapy resulted in improved (p <= 0.05) cervical spine ROM in all six physiological cervical spine movement directions immediately post-treatment and at 12 weeks. Treatment with PJM resulted in improvement in one of the six cervical movement directions post-treatment, and one movement direction at 12 weeks. There was a greater improvement (p < 0.01) after SNAGs than PJM in extension (mean difference -7.5 degrees, 95% CI -13 to -2.0) and right rotation (-6.8, -11.5 to -2.1) post treatment. Manual therapy had no effect on balance or head repositioning accuracy. CONCLUSIONS: SNAG treatment, improved cervical ROM and the effects were maintained for 12 weeks after treatment. PJM had very limited impact on cervical ROM. There was no conclusive effect of SNAGs or PJMs on joint repositioning accuracy or balance in people with cervicogenic dizziness.

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