title: Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin.
abstract: OBJECTIVE
  To assess postural performance in patients with dizziness of suspected cervical origin in whom extracervical causes had been excluded, and to assess the effects of physiotherapy on postural performance and subjective complaints of neck pain and dizziness.
  
  
  METHODS
  Prospective, randomized, controlled trial.
  
  
  METHODS
  Primary care centers and a tertiary referral center.
  
  
  METHODS
  Of 65 referrals, 43 patients were excluded because extracervical etiology was suspected. Of the remaining 22 patients, 17 completed the study (15 women, 2 men, x age 37 yr, range 26-49). The controls were 17 healthy subjects (15 women, 2 men, x age 36 yr, range 25-55).
  
  
  METHODS
  Physiotherapy based on analysis of symptoms and findings, and aimed to reduce cervical discomfort. Patients were randomized either to receive immediate physiotherapy (n = 9), or to wait 2 months, undergo repeat measurements, and then receive physiotherapy (n = 8).
  
  
  METHODS
  Posturography, measuring velocity and variance of vibration-induced body sway and variance of galvanically induced body sway. Subjective intensity of neck pain (Visual Analog Scale ratings, 0-100), intensity and frequency of dizziness (subjective score 0-4).
  
  
  RESULTS
  The patients manifested significantly poorer postural performance than did healthy subjects (.05 > p > .0001). Physiotherapy significantly reduced neck pain and intensity and the frequency of dizziness (p < .01), and significantly improved postural performance (.05 > p > .0007).
  
  
  CONCLUSIONS
  Patients with dizziness of suspected cervical origin are characterized by impaired postural performance. Physiotherapy reduces neck pain and dizziness and improves postural performance. Neck disorders should be considered when assessing patients complaining of dizziness, but alternative diagnoses are common.
authors.affiliation: Department of Oto-Rhino-Laryngology, University Hospital, Lund, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Karlberg
authors.forename: M
authors.initials: M
authors.lastname: Magnusson
authors.forename: E M
authors.initials: EM
authors.lastname: Malmström
authors.forename: A
authors.initials: A
authors.lastname: Melander
authors.forename: U
authors.initials: U
authors.lastname: Moritz
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries; D004244:Dizziness / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014732:Vibration