Effect of Vestibular Rehabilitation Combined with Cervical Manual Therapy in Patients with Cervicogenic Dizziness: A Randomized Controlled Trial

Nida Pervaiz; Muhammad Baqir; Muhammad Usman; Syeda Maria Nazir; Ismail khan; Sara Tariq

doi:10.61919/efvjb405

Authors

Nida Pervaiz Deputy Section Head, Iqra APS, Quetta, Pakistan Author
Muhammad Baqir Physiotherapist, Mubarak Medical Center, Abu Dhabi, United Arab Emirates Author
Muhammad Usman Visiting Lecturer, Comwave Institute, Khanna Pul, Islamabad, Pakistan Author
Syeda Maria Nazir Physical Therapist, New Akram Pharmacy and Specialist Clinics, Wah Cantt, Pakistan Author
Ismail khan Chairman, Dr. Physio Rehab, Islamabad, Pakistan Author
Sara Tariq DPT Student, Ibadat Internal University, Islamabad, Pakistan Author

DOI:

https://doi.org/10.61919/efvjb405

Keywords:

Cervicogenic dizziness; Vestibular rehabilitation; Cervical manual therapy; Dizziness Handicap Inventory; Randomized controlled trial; Physiotherapy

Abstract

Background: Cervicogenic dizziness is associated with cervical dysfunction and disturbed integration of cervical proprioceptive, vestibular, and visual information. Evidence regarding rehabilitation programs simultaneously addressing cervical and vestibular impairments remains limited. Objective: To compare vestibular rehabilitation combined with cervical manual therapy and cervical exercises with vestibular rehabilitation alone in patients with cervicogenic dizziness. Methods: This multicenter randomized controlled trial included 60 participants allocated equally to experimental and control groups. Both groups received vestibular rehabilitation three times weekly for six weeks; the experimental group additionally received cervical manual therapy and cervical home exercises. Dizziness Handicap Inventory (DHI), Visual Analogue Scale, Neck Disability Index, Berg Balance Scale, cervical Joint Position Error, and cervical range of motion were assessed at baseline, Week 6, and Week 12. Outcomes were analyzed using mixed repeated-measures ANOVA with Bonferroni-adjusted comparisons. Results: DHI decreased from 55.4 ± 8.3 to 17.2 ± 4.4 in the experimental group and from 55.9 ± 8.5 to 32.0 ± 6.3 in controls. At Week 12, the between-group DHI difference was −14.8 points. Significant group × time interactions occurred for all outcomes (partial η² = 0.30–0.41; p < 0.001), with greater improvements in pain, disability, balance, proprioception, and cervical mobility in the experimental group. Conclusion: A multimodal cervical-plus-vestibular rehabilitation program produced greater short-term improvement than vestibular rehabilitation alone in patients with cervicogenic dizziness

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