Effects of Oculomotor Exercises in Patients With Non Traumatic Cervical Dizziness

Effects of Oculomotor Exercises on Pain, Disability, Dizziness and Gaze Stability in Patients With Non Traumatic Cervical Dizziness

To investigate the effects of oculomotor exercises on pain disability, dizziness and gaze stability in patients with non-traumatic cervical dizziness.

A randomized controlled trial compared routine exercise with a combination of oculomotor exercises (OEs) and manual myofascial techniques (MFT) in patients with chronic non-specific neck pain (CNNP). Thirty-eight participants were randomly allocated into two groups, and both groups completed a six-week exercise program, while the intervention group additionally received OEs and manual MFT. Outcome measures included pain intensity, cervical range of motion (ROM), proprioception, kinesiophobia, and disability. Both groups showed significant improvements after treatment. However, the group receiving OEs and manual MFT demonstrated significantly greater improvements in cervical ROM, pain, disability, proprioception, and kinesiophobia compared to the routine exercise group. These findings suggest that adding OEs and manual MFT may enhance rehabilitation outcomes in patients with CNNP.

A comparative study evaluated manual therapy alone versus manual therapy combined with proprioception training in patients with cervicogenic dizziness (CGD) and chronic neck pain (CNP). Twenty participants were divided into two groups, with ten patients in each group. One group received manual therapy, while the other received manual therapy along with proprioception training. Outcome measures included joint position error sense (JPSE), smooth pursuit performance, Dizziness Handicap Inventory (DHI), and dizziness visual analogue scale (VAS). Both groups showed significant improvements following treatment; however, the combined therapy group demonstrated greater improvements in proprioception, eye movement control, dizziness severity, and disability. These findings indicate that adding proprioception training to manual therapy may provide superior therapeutic benefits for patients with CGD and CNP.

A randomized controlled trial investigated the effectiveness of tactile discrimination training (TDT) and OEs in individuals with chronic neck pain. Fifty-seven participants were randomly assigned to a TDT group, an OE group, or a control group that received no intervention. Both intervention groups underwent treatment three times per week for four weeks. Outcomes included pain intensity, neck pain-related disability, pressure pain thresholds, mechanical temporal summation of pain, and conditioned pain modulation. Significant improvements in pain intensity and neck-related disability were observed in both intervention groups compared with the control group. However, the OEs group demonstrated greater reductions in pain intensity and greater improvements in pressure pain thresholds than the TDT group. These findings suggest that both TDT and OEs may be effective in reducing pain and disability in patients with chronic neck pain, with OEs providing greater clinical benefits.

A multicenter randomized controlled trial compared three vestibular rehabilitation approaches in patients with unilateral peripheral vestibular dysfunction. Thirty-four participants were randomly assigned to customized vestibular rehabilitation therapy, generic vestibular rehabilitation therapy using Cawthorne-Cooksey exercises, or vestibulo-ocular reflex (VOR) adaptation exercises, with 23 participants completing the study. Outcomes included dizziness-related disability, balance, and visual stability. All three intervention groups demonstrated significant improvements following treatment. However, participants performing gaze stabilization exercises demonstrated greater reductions in dizziness-related disability and superior improvements in balance. These findings highlight the potential importance of gaze stabilization training as a component of vestibular rehabilitation, particularly in individuals with gaze stability impairments.

A randomized controlled trial compared the short- and long-term effects of two manual therapy approaches in patients with chronic cervicogenic dizziness. Eighty-six participants were randomly allocated to groups receiving SNAGs with self-SNAG exercises, passive joint mobilizations with ROM exercises, or a placebo intervention. Participants received treatment sessions over six weeks, with outcomes assessed up to 12 months. Both manual therapy groups demonstrated significant reductions in dizziness intensity and frequency, improvements in cervical ROM, and lower dizziness-related disability compared with the placebo group. The SNAG intervention produced greater improvements in cervical mobility and balance performance, while passive joint mobilization resulted in greater improvements in dizziness-related disability and pain reduction.

A randomized controlled study investigated the effects of oculomotor exercises in patients with chronic non-specific neck pain and associated visual complaints. Thirty-two participants were randomly allocated into two groups. The control group received stretching exercises for the sternocleidomastoid and anterior scalene muscles along with neck isometric exercises, whereas the experimental group received the same conventional treatment in addition to a structured OEs program consisting of saccadic eye movements, smooth pursuit exercises, convergence training, and gaze stabilization exercises. Outcomes included pain intensity, the Neck Disability Index (NDI), gaze stability, and visual symptoms. Significant improvements were observed in neck pain, disability, gaze stability, and visual complaints following the intervention. Improvements in eye-head coordination and sensorimotor control were also reported, suggesting that OEs may be beneficial for reducing pain and disability while improving gaze stability and visual function in patients with chronic neck pain.

A randomized controlled trial compared OEs combined with a cervical proprioceptive training program with cervical proprioceptive training alone in patients with chronic neck pain. Forty-eight patients were equally randomized into two groups. The intervention was applied three times per week for eight weeks, resulting in 24 sessions. Both groups demonstrated significant improvements in deep cervical flexor muscle activation and function. However, greater improvements in deep cervical flexor activation and functional outcomes were observed in the group receiving combined cervical proprioceptive and oculomotor training. These findings suggest that combining OEs with cervical proprioceptive training may provide additional benefits for improving clinical symptoms in patients with chronic neck pain.

A randomized controlled trial evaluated the efficacy of a self-exercise program in patients with cervicogenic dizziness. Thirty-two participants were randomly allocated to a self-exercise group or a control group. The self-exercise program included muscle strengthening, cervical mobilization, and osteopathic manipulative exercises performed at home, while the control group received no specific exercise intervention. Outcomes were assessed using the DHI, NDI, VAS, cervical ROM, and posturography tests. The self-exercise group demonstrated significantly greater improvements in dizziness-related disability and neck disability compared with the control group. However, no significant between-group differences were observed in pain intensity, cervical ROM, or balance measures.

A randomized controlled trial evaluated the effectiveness of adding sensorimotor training, including oculomotor and gaze stability exercises, to standard neck exercises in patients with chronic neck pain and dizziness. Seventy-two patients were randomly assigned to a standard neck exercise group or a combined sensorimotor training group. The intervention lasted ten weeks, and outcomes included neck pain intensity, disability, dizziness, balance, and gaze stability. The combined intervention demonstrated significantly greater improvements in dizziness, gaze stability, and balance compared with standard neck exercises. Greater reductions in neck pain and disability were also reported, suggesting that incorporating sensorimotor and oculomotor exercises may enhance rehabilitation outcomes in patients with chronic neck pain and associated dizziness.

A randomized controlled trial investigated the postural and clinical outcomes of SNAGs treatment in patients with cervicogenic dizziness. Eighty-nine patients were randomly assigned to either a SNAGs intervention group or a placebo group receiving a detuned laser. Both groups received six intervention sessions over four weeks. The SNAGs group demonstrated a significant reduction in perceived dizziness, neck disability, and pain, along with significant improvements in cervical ROM and selected posturographic parameters.

A randomized controlled trial investigated the short-term effects of a traction-manipulation protocol on dizziness intensity and disability in patients with cervicogenic dizziness. Forty participants were randomly assigned to an intervention group receiving traction-manipulation treatment or a control group that remained in a supine position. The intervention was delivered according to safety recommendations. Outcomes included dizziness intensity, pain intensity, DHI, cervical ROM, and balance, assessed at 48 hours and one month after treatment. The intervention group demonstrated significantly greater improvements in dizziness, neck pain, DHI scores, and upper cervical mobility compared with the control group at both follow-up periods. Postural stability also improved significantly in the intervention group at one month. These findings indicate that traction-manipulation may be effective for reducing dizziness and pain while improving cervical function and balance in patients with cervicogenic dizziness.

Inclusion Criteria:

• Both Males and Females
• Age between 20 and 40 years with nontraumatic cervical dizziness.
• Patients experiencing symptoms of cervicogenic dizziness for at least 3 months (chronic cervicogenic dizziness)
• Patients having a Numeric Pain Rating Scale (NPRS) score greater than or equal to 3
• Patient with positive Flexion Rotation Test (FRT)
• Cervical Torsion Test
• Patients have never received oculomotor exercises and SNAGS before.

Exclusion Criteria:

• History of trauma or recent surgery to the head, face, neck, or chest.
• Diagnosis of central vertigo (e.g., brainstem or cerebellar pathology).
• Presence of vestibular-origin vertigo, such as benign paroxysmal positional vertigo (BPPV).
• Triage (Patients with traumatic cervical spine injury, Cervical arterial dysfunction and central vestibular disorders
• Inability to perform exercises (e.g., due to cervical fracture)