Effects of Vestibular Exercises and Motor Control in Cervicogenic Dizziness

NCT ID: NCT05125250

Last Updated: 2022-12-12

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 34 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-11-15
• Study Completion Date: 2022-06-30

Brief Summary

The feelings of imbalance, unsteadiness, and disorientation with cervicogenic dizziness is not clear. It has been suggested that a disruption of the normal afferent signals from the upper cervical proprioceptors to the vestibular nucleus results in an inaccurate depiction of head and neck orientation in space due to highly developed proprioceptive system that allows the neuromuscular control of cervical spine and effective use of vital organs in the head through unique connections to the vestibular and visual systems. Motor Control Therapeutic Exercises and vestibular exercises have been used to increase motor control and reduce pain and disability in patients with neck pain.

Detailed Description

Cervicogenic dizziness is defined as a sensation of instability or disequilibrium that occurs with the pain and stiffness in cervical spine and is aggravated by neck movements or positions. Dizziness is a common indication in people with cervical spine dysfunction. cervicogenic dizziness as "a nonspecific sensation of altered orientation in space and disequilibrium originating from abnormal afferent activity from the neck" which is thought to be caused by disorders in the upper cervical spine and commonly it is associated with cervical stiffness neck pain or headache.

Motor control can also be defined as the capacity of how the central nervous system produces of useful movements that are coordinated and integrated with the rest of the body and the environment. Thus, motor control therapeutic exercises (MCTE) are used to improve the conditions of patients. Motor Control Therapeutic Exercises have been used to increase motor control and reduce pain and disability in patients with neck pain. MCTE comprised of cranio-cervical flexor exercise, cranio-cervical extensor exercise, co-contraction of flexors and extensors, a synergy exercise for retraining the strength of the deep neck flexors.

Schenk et al. have published case studies in which they describe the diagnosis, treatment, and outcomes of a patient with cervicogenic dizziness co-managed by a vestibular and an orthopedic manual physical therapist. They argue that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness. Literature states that vestibular exercises have been used to increase motor control and reduce pain and disability in patients with neck pain.

Conditions

Cervical Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: SINGLE

Study Groups

Motor Control Group

This group will receive treatment which comprises of therapeutic exercises, During the first 4 weeks, motor control and ROM exercises will be prescribed in order to improve muscular endurance of deep flexors muscles and to improve the ROM of cervical spine in flexion, extension, rotation and side bending and lateral rotation in. These exercises will be performed at a rate of 3 sets and an intensity of 15 repetitions per day

Group Type: EXPERIMENTAL

Motor Control Group

Intervention Type: OTHER

will received treatment which comprises of therapeutic exercises, During the first 4 weeks, motor control and ROM exercises will be prescribed in order to improve muscular endurance of deep flexors muscles and to improve the ROM of cervical spine in flexion, extension, rotation and side bending and lateral rotation in. These exercises will be performed at a rate of 3 sets and an intensity of 15 repetitions per day .

Vestibular Group

This Group will receive vestibular exercises which comprises of postural awareness training; Standing on a balance board, Foveal vision exercises.

Group Type: ACTIVE_COMPARATOR

Vestibular Group

Intervention Type: OTHER

will receive vestibular exercises which comprises of postural awareness training, balance board exercises, Foveal vision exercises .

Interventions

Motor Control Group

will received treatment which comprises of therapeutic exercises, During the first 4 weeks, motor control and ROM exercises will be prescribed in order to improve muscular endurance of deep flexors muscles and to improve the ROM of cervical spine in flexion, extension, rotation and side bending and lateral rotation in. These exercises will be performed at a rate of 3 sets and an intensity of 15 repetitions per day .

Intervention Type: OTHER

Vestibular Group

will receive vestibular exercises which comprises of postural awareness training, balance board exercises, Foveal vision exercises .

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• • Age: 30-65 years

• Gender both
• Pain and dizziness lasting for at least 3 months;
• Pain intensity corresponding to at least 3 points on a 10-point numeric pain rating scale;
• Restricted cervical range of movement (flexion, extension, rotation and side-bending);
• Presence of neck pain associated with disability according to the NDI greater than or equal to 5 points;
• Presence of subjective dizziness associated with pain, movement, stiffness or specific postures of the cervical region

Exclusion Criteria

• • Any other systemic or neurodegenerative pathology, presence of trauma or recent surgery to the head, face, neck or chest;

• specific diagnosis of central or peripheral dizziness;
• History of previous physical-therapy intervention for the cervical region;
• Any cognitive impairment that hindered viewing of audiovisual material;
• Difficulty understanding or communicating

• Minimum Eligible Age: 30 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Misbah Ghous

Role: PRINCIPAL_INVESTIGATOR

Riphah college of Rehabilitation and Allied Health sciences Islamabad

Locations

Pakistan General Railway Hospital

Rawalpindi, , Pakistan

Countries

Pakistan

References

Lystad RP, Bell G, Bonnevie-Svendsen M, Carter CV. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropr Man Therap. 2011 Sep 18;19(1):21. doi: 10.1186/2045-709X-19-21.

Reference Type: BACKGROUND

PMID: 21923933 (View on PubMed)

4. Schenk RP, Coons LB, Bennett SE, Huijbregts PA. Cervicogenic dizziness: a case report illustrating orthopaedic manual and vestibular physical therapy comanagement. Journal of Manual & Manipulative Therapy. 2006 Jul 1;14(3):56E-68E.

Reference Type: BACKGROUND

Schenk R, Coons LB, Bennett SE, Huijbregts PA: Cervicogenic dizziness: A case report illustrating manual and vestibular physical therapy comanagement. The Journal of Manual & Manipulative Therapy. 2006, 14 (3): E56-E68.

Reference Type: BACKGROUND

Other Identifiers

REC/00963 Amber

Identifier Type: -

Identifier Source: org_study_id