title: Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?
abstract: BACKGROUND
  Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with CST, but no experimental studies are available.
  
  
  OBJECTIVE
  To investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with CST.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Patients with a combination of severe subjective tinnitus (Tinnitus Functional Index (TFI): 25-90 points) and neck complaints (Neck Bournemouth Questionnaire (NBQ) > 14 points).
  
  
  METHODS
  All patients received cervical physical therapy for 6 weeks (12 sessions). Patients were randomized in an immediate-start therapy group (n = 19) and a 6-week delayed-start therapy group (n = 19).
  
  
  METHODS
  TFI and NBQ-scores were documented at baseline, after the wait-and-see period in the delayed-start group, after treatment and after 6 weeks follow-up. The Global Perceived Effect (GPE) was documented at all measuring moments, except at baseline.
  
  
  RESULTS
  In all patients (n = 38) TFI and NBQ-scores decreased significantly after treatment (p = 0.04 and p < 0.001). NBQ-scores remained significantly lower after follow-up (p = 0.001). Immediately after treatment, 53% (n = 38) experienced substantial improvement of tinnitus. This effect was maintained in 24% of patients after follow-up at six weeks.
  
  
  CONCLUSIONS
  Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect.
  
  
  BACKGROUND
  NCT02016313.
authors: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium. Electronic address: sarah.michiels@uantwerpen.be.
authors: S
authors: S
authors: Michiels
authors: Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium; Multidisciplinary Motor Centre Antwerp, University of Antwerp, Antwerp, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
authors: P
authors: P
authors: Van de Heyning
authors: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp, University of Antwerp, Antwerp, Belgium.
authors: S
authors: S
authors: Truijen
authors: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Multidisciplinary Motor Centre Antwerp, University of Antwerp, Antwerp, Belgium; Laboratory of Functional Morphology, Faculty of Science, University of Antwerp, Antwerp, Belgium.
authors: A
authors: A
authors: Hallemans
authors: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
authors: W
authors: W
authors: De Hertogh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000503:physiopathology* / Q000628:therapy*; D026741:Physical Therapy Modalities; D020886:Somatosensory Disorders / Q000175:diagnosis* / Q000628:therapy*; D014012:Tinnitus / Q000628:therapy*; D016896:Treatment Outcome
keywords: Cervical spine; Physical therapy; Somatic tinnitus; Treatment