Effectiveness of manual therapy in dizziness intensity and cervical range of motion in patients with cervicogenic dizziness: A systematic review

Abstract

Cervicogenic dizziness appears in 35-40 % of patients affected with neck pain. Conservative physical therapy treatment for this pathology is increasingly present in the scientific literature, However, there is limited evidence regarding the long-term effects of manual therapy on dizziness intensity and cervical range of motion (ROM). This research aims to address these gaps by analyzing the existing evidence to determine the efficacy of manual therapy for patients with cervicogenic dizziness.

Objective: To determine the effect of manual therapy in dizziness intensity and cervical range of motion in patients affected with cervicogenic dizziness.

Material and methods: A bibliographic search was carried out in the following databases: Pubmed, PEDro, WOS, Scopus and CINAHL from February to March 2022 and an update was carried out during March 2024. Randomized clinical trials were included with a minimum sample of 20 subjects, published in English, conducted on human subjects, with the presence of a group diagnosed with cervicogenic dizziness (CD) that received manual therapy treatment, and required to have a score on the PEDro scale ≥7. For the evaluation of the methodological quality, PEDro scale was used. For risk of bias assessment, the Cochrane RoB 2.0 tool was applied. The main outcomes studied were: dizziness intensity and cervical range of motion (ROM). Pain intensity, frequency of dizziness and functionality were also studied as secondary outcomes.

Results: After applying the inclusion and exclusion criteria, a total of 8 articles were included for qualitative analysis. The mean score on the PEDro scale was 8.12 points. Most articles reflected a decrease in the intensity of dizziness and an increase in ROM in the short term, describing inconsistencies in the long term.

Conclusion: Scientific evidence supports the effect of manual therapy in patients with cervicogenic dizziness in terms of modifying the intensity of dizziness and cervical ROM, at least in the short term. While short-term benefits are consistent, long-term effects remain uncertain. Further research is recommended to explore lasting outcomes and optimize treatment approaches.