Chuna Manual Therapy for Cervicogenic Dizziness

Therapeutic Effect of Adjuvant Chuna Manual Therapy (CMT) in Subjects With Cervicogenic Dizziness: a Prospective, Pragmatic, Assessor-blind, Randomized Controlled Trial

This is a prospective, pragmatic, assessor-blind, randomized controlled trial to explore the effectiveness of an adjuvant Chuna manual therapy (CMT) for cervicogenic dizziness of Dizziness Handicap Inventory (DHI) ≥ 16 at baseline. Participants will be randomized and allocated to either CMT combined with usual care (UC) group or UC group with 1:1 ratio. They will receive 12 sessions of CMT or UC treatment for 6 weeks. UC consists of physical therapy and patients education.

Inclusion Criteria:

• male or female aged between 20 and 70
• neck pain and/or stiffness with dizziness, which is related to movement or positioning of cervical spine
• recurring symptom of dizziness over 1 month or more
• Dizziness Handicap Inventory ≥ 16 at baseline
• Informed consent

Exclusion Criteria:

• dizziness induced by vestibular disorders (e.g., benign paroxysmal positional vertigo, peripheral vestibulopathy, Meniere disease, vestibular neuronitis)
• dizziness induced by central nervous system (CNS) disorders (e.g., cerebellar ataxia,cerebellum infarction/hemorrhage, demyelination, vertebrobasilar insufficiency, seizure, increased intracranial pressure, Parkinson's disease, migraines)
• dizziness induced by cardiovascular disorders (e.g., arrhythmia, heart valvular disease, anemia, orthostatic hypotension, coronary artery disease)
• dizziness induced by active or uncontrolled disease (e.g., uncontrolled diabetes mellitus, hypertension, respiratory or endocrinological disorders)
• dizziness induced by side effects of medications
• severe chronic or terminal diseases (malignant cancer, tuberculosis, etc.)
• chronic psychiatric diseases under treatment (epilepsy, depression, panic disorder, etc.)
• conditions where CMT are forbidden (spinal tumor, acute fracture, infectious spondylopathy, congenital malformations of spine, operation history of spine within 3 months, progressive neurological damage, severe neurological symptoms, spinal fixation devices, syringomyelia, hydrocephaly)
• Treatment history within 1 week for cervicogenic dizziness (NSAIDs, steroid, herbal drug, acupuncture, manual therapy)
• Women of (suspected) pregnancy or breast-feeding
• Suspicion of alcohol and/or drug abuse
• Participation in another clinical study within 1 month
• Difficulty in communicating with the investigators
• Other reasons for ineligibility of participation