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Postural and clinical outcomes of sustained natural apophyseal glides treatment in cervicogenic dizziness patients: a randomised controlled trial [with consumer summary]
Micarelli A, Viziano A, Granito I, Carlino P, Micarelli RX, Augimeri I, Alessandrini M
Clinical Rehabilitation 2021 Nov;35(11):1566-1576
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 +/- 14.8 years) receiving treatment, and 39 patients (18 male, 21 female: mean age 43.8 +/- 13.9 years) 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 weeks. 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 +/- 5.3 as compared to 26.2 +/- 6 baseline), neck disability and pain (Neck Disability Index and Neck Pain Index post-treatment scores 12.5 +/- 4.3 and 45.6 +/- 15.1, respectively, as compared to baseline scores of 15.1 +/- 4.8 and 62.5 +/- 14.3), 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.

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