Article

There is short-term evidence for treatment of cervicogenic dizziness
with Mulligan sustained natural apophyseal glides (SNAGs) but no evidence for
treatment with Maitland mobilizations.
The purpose of this study was
to compare the effectiveness of SNAGs and Maitland mobilizations for cervicogenic
dizziness. DESIGN: A double-blind, parallel-arm randomized controlled trial was
conducted. SETTING: The study was conducted at a university in Newcastle,
Australia. PARTICIPANTS: Eighty-six people with cervicogenic dizziness were the
study participants. INTERVENTIONS: Included participants were randomly allocated
to receive 1 of 3 interventions: Mulligan SNAGs (including self-administered
SNAGs), Maitland mobilizations plus range-of-motion exercises, or placebo.
MEASUREMENTS: The primary outcome measure was intensity of dizziness. Other
outcome measures were: frequency of dizziness, the Dizziness Handicap Inventory
(DHI), intensity of pain, and global perceived effect (GPE). RESULTS: Both manual
therapy groups had reduced dizziness intensity and frequency posttreatment and at
12 weeks compared with baseline. There was no change in the placebo group. Both
manual therapy groups had less dizziness intensity posttreatment (SNAGs: mean
difference=-20.7, 95% confidence interval [95% CI]=-33.6, -7.7; mobilizations:
mean difference=-15.2, 95% CI=-27.9, -2.4) and at 12 weeks (SNAGs: mean
difference=-18.4, 95% CI=-31.3, -5.4; mobilizations: mean difference=-14.4, 95%
CI=-27.4, -1.5) compared with the placebo group. Compared with the placebo group,
both the SNAG and Maitland mobilization groups had less frequency of dizziness at
12 weeks. There were no differences between the 2 manual therapy interventions
for these dizziness measures. For DHI and pain, all 3 groups improved
posttreatment and at 12 weeks. Both manual therapy groups reported a higher GPE
compared with the placebo group. There were no treatment-related adverse effects
lasting longer than 24 hours. LIMITATIONS: The therapist performing the
interventions was not blind to group allocation. CONCLUSIONS: Both SNAGs and
Maitland mobilizations provide comparable immediate and sustained (12 weeks)
reductions in intensity and frequency of chronic cervicogenic dizziness.

Langue : ANGLAIS