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The effect of neck-specific exercise and prescribed physical activity on headache and dizziness in individuals with cervical radiculopathy: further analyses of a randomized study with a 1-year follow-up [with consumer summary]
Svensson J, Peolsson A, Hermansen A, Cross JJ, Abbott A, Cleland JA, Kierkegaard M, Halvorsen M, Dedering A
Physiotherapy Theory and Practice 2024;40(4):714-726
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; 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 the effect of neck-specific exercise (NSE) compared to prescribed physical activity (PPA) on headache and dizziness in individuals with cervical radiculopathy (CR). Also, to investigate associations between headache or dizziness and pain, neck muscle endurance (NME), neck mobility, physical activity, and fear avoidance beliefs. METHODS: Individuals randomized to either NSE or PPA were selected to a headache subgroup (n = 59) and/or a dizziness subgroup (n = 73). Data were evaluated, according to headache and/or dizziness outcomes at baseline and at 3, 6, and 12-month follow-ups. RESULTS: No significant between-group differences were found between NSE and PPA in either subgroup. In the headache subgroup, significant within-group improvements were seen at all follow-ups for NSE (p < 0.001) and from baseline to 3 (p = 0.037) and 12 (p = 0.003) months for PPA. For dizziness, significant within-group improvements were seen from baseline to 3 months for NSE (p = 0.021) and from baseline to 3 (p = 0.001) and 6 (p = 0.044) months for PPA. Multiple regression models showed significant associations at baseline between headache intensity and neck pain (adjusted R-square = 0.35, p < 0.001), and for dizziness with neck pain and dorsal NME (adjusted R-square = 0.34, p < 0.001). CONCLUSION: NSE and PPA show similar improvements in headache intensity and dizziness in individuals with CR. Headache intensity is associated with neck pain, and dizziness with neck pain and dorsal NME, highlighting the importance of these factors when evaluating headache and dizziness.

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