title: Comparison of mulligan sustained natural apophyseal glides and maitland mobilizations for treatment of cervicogenic dizziness: a randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  The purpose of this study was to compare the effectiveness of SNAGs and Maitland mobilizations for cervicogenic dizziness.
  
  
  METHODS
  A double-blind, parallel-arm randomized controlled trial was conducted.
  
  
  METHODS
  The study was conducted at a university in Newcastle, Australia.
  
  
  METHODS
  Eighty-six people with cervicogenic dizziness were the study participants.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: S.A. Reid, BAppSc(Phty), GradDipManipTher, MMedSc(Phty), BPharm, School of Physiotherapy, Australian Catholic University, PO Box 968, North Sydney, New South Wales, 2059, Australia.
authors: Susan A
authors: SA
authors: Reid
authors: Darren A
authors: DA
authors: Rivett
authors: Michael G
authors: MG
authors: Katekar
authors: Robin
authors: R
authors: Callister
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D004244:Dizziness / Q000209:etiology* / Q000628:therapy*; D004311:Double-Blind Method; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal; D008405:Massage; D008875:Middle Aged; D016059:Range of Motion, Articular; D013122:Spinal Diseases / Q000150:complications*; D016896:Treatment Outcome; D055815:Young Adult