The effectiveness of manual therapy in treating cervicogenic dizziness: a systematic review.
Khalid Yaseen, Paul Hendrick, Ayah Ismail and 2 others
PMID 29410575WHAT IT FOUND
Manual therapy for suspected cervicogenic dizziness showed consistent short-term benefit across four trials, but long-term intensity improvement was not significant.
Evidence was rated moderate. One trial combined manual therapy with other physiotherapy.
Key findings
01The review found consistent beneficial effects of manual therapy for cervicogenic dizziness and rated the evidence as moderate.
02Post-treatment trials reported significant improvement in dizziness intensity with manual therapy compared with placebo.
03At 12 months, dizziness intensity was not significantly different from placebo, but frequency and DHI still showed significant improvement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only four trials were available, and they used different manual therapy techniques, outcome tools, and follow-up periods. The review could not pool results because the studies were too heterogeneous. One included trial had only 17 participants and used a multimodal physiotherapy package, so manual therapy alone cannot be separated from other treatments. Therapists were not blinded, and patient blinding was often not reported or not achieved. Only one included trial was performed by researchers other than the group that conducted the other included trials. No trial compared manual therapy with other conservative interventions such as neck exercises or stabilisation. Differential diagnosis relied on clinical examination and exclusion of other causes, but no consensus diagnostic tests were available. The search was limited to English-language studies.
The easy way to misread this
Do not conclude that manual therapy alone reliably treats cervicogenic dizziness. The review included four trials, one trial combined manual therapy with other physiotherapy, and intensity results at 12 months were not significant.