Review articleManual therapy treatment of cervicogenic dizziness: a systematic review
Section snippets
Background
Dizziness is a common complaint in manual therapy and practice. It can be described as light-headedness, imbalance, giddiness or unsteadiness (Oostendorp et al., 1992a). It is a symptom of non-specific pathological importance (Luxon, 1984). A subgroup of those with dizziness complains of vertigo which is an illusion of movement, usually rotation, whirling or spinning of the person or the environment (Froehling et al., 1994; Cronin, 1997; Aalto et al., 1998).
Dizziness and vertigo are common
Objective
The purpose of this study was to systematically review the literature to evaluate the evidence for the efficacy of manual therapy treatment in the management of cervicogenic dizziness. The review examines the evidence in order to inform practitioners.
Literature search
Several bibliographic databases were searched in July 2003. The following electronic databases were searched: MEDLINE using OVID (January 1, 1966 onwards), EMBASE (1988 onwards), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (from 1983 onwards), Physiotherapy Evidence Database (PEDro), the Cochrane Controlled Trials Register in the Cochrane Library (latest edition), Manual Alternative and Natural Therapy Index System (MANTIS) (1880 onwards) and the Allied and Complementary
Selection of studies
Twenty-six trials were identified using MEDLINE. These were scanned and three trials were identified that met the criteria for inclusion (Karlberg et al., 1996; Bracher et al., 2000; Heikkila et al., 2000). The search of EMBASE identified three German studies (Konrad and Gereneser, 1990; Uhlemann et al., 1993; Biesinger, 1997). The search of AMED identified a further study accepted for the review (Zhou et al., 1999). PEDro, MANTIS, CINAHL and the Cochrane Controlled Trials Register did not
Discussion
Results from the studies examined in this systematic review showed that there is limited evidence that manual therapy is beneficial in the treatment of cervicogenic dizziness.
Due to the lack of RCTs on this topic non-RCTs were included. It has been acknowledged that RCTs are not the only or necessarily the best means of evaluating health care, and the Cochrane Collaboration has considered changing to include other research methodologies (Newman and Jacobsen 1993; Mulrow and Oxman, 1997).
Conclusions
This systematic review has found that there is limited evidence at present to support the use of manual therapy in treating cervicogenic dizziness. Insufficient clinical research of satisfactory quality has been performed on this topic. Further RCTs, with high-methodological quality, are needed to clearly determine the role of manual therapy for this disorder. Future research should examine the efficacy of individual types of manual therapy as well as a multimodal approach.
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