Sustained Natural Apophyseal Glides With and Without Facilitated Positional Release Technique in Cervicogenic Dizziness

Effects of Sustained Natural Apophyseal Glides With and Without Facilitated Positional Release Technique on Pain, Dizziness, Range of Motion, and Functional Status Among Patients With Cervicogenic Dizziness

Cervicogenic Dizziness is characterized by non-rotatory dizziness and a sense of disequilibrium associated with neck pain, stiffness, and decreased range of motion. It arises from the abnormal afferent inputs from the upper cervical spine. Patients may experience lightheadedness and neck pain triggered by neck movements, leading to functional limitations. The present study aims to compare the effects of sustained natural apophyseal glides only and in combination with the facilitated positional release technique on pain intensity, severity of dizziness, range of motion, and functional status among patients with cervicogenic dizziness

A double-blinded randomized clinical trial will be conducted at the Government Teaching Hospital, Shahdara, Lahore. A total of 42 patients (21 in each group) will be enrolled in this study, and a non-probability, purposive sampling technique will be used for data collection. Patients will be allocated to Group A and Group B after randomization using an online randomization tool. After obtaining informed consent, Group A will receive treatment of SNAGs along with FPRT, while Group B will receive SNAGs only, three times a week for four weeks. Outcome measures will include the Numeric Pain Rating Scale (NPRS) for pain, the Dizziness Handicap Inventory Scale (DHI) for dizziness, a goniometer for range of motion, and the Neck Disability Index (NDI) for functional status. Assessment will be conducted on the first day and after four weeks of treatment. Data will be analyzed using SPSS version 27. Descriptive statistics will be presented, and the data normality will be assessed using the Shapiro-Wilk test to determine whether a parametric or non-parametric test will be used within or between-group analyses.

Inclusion Criteria:

• Age group between 18 and 35 years
• Both male and female participants
• Non-traumatic cervicogenic dizziness with positive cervical torsion test

Exclusion Criteria:

• • History of cervical trauma or head/face injury

  • Vestibular disorder, i.e., BPPV
  • Vertebrobasilar Insufficiency
  • Positive Dix-Hallpike Maneuver, Alar Ligament Stress Test, and Vertebral Artery Test
  • History of cardiovascular disorders
  • Pregnancy
  • Diagnosed psychological disorders
  • History of cervical spine surgery
  • Vertebral Fractures
  • Spine disorders such as cervical spondylosis and disc herniation
  • Presence of tumor