title: Prognostic indicators for decrease in tinnitus severity after cervical physical therapy in patients with cervicogenic somatic tinnitus.
abstract: 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). Recently, a positive effect of multi-modal cervical physical therapy on tinnitus severity in patients with CST was demonstrated. To date however, the outcome of the intervention cannot be predicted.
  
  
  
  To identify prognostic indicators for decrease in tinnitus severity after cervical physical therapy in patients with CST.
  
  
  
  Patients with moderate to severe subjective tinnitus (Tinnitus Functional Index(TFI):25-90points) and neck complaints (Neck Bournemouth Questionnaire(NBQ) > 14points).
  
  
  
  All patients received multimodal cervical physical therapy for 6 weeks (12 sessions). This physical therapy contained a combination of manual mobilizations and exercises of the cervical spine.
  
  
  
  TFI and NBQ-scores were documented at baseline, after treatment and after a 6-weeks follow-up period. Impairments in cervical spine mobility and muscle function were identified at baseline and after 6-weeks follow-up.
  
  
  
  Patients with co-varying (increasing or decreasing simultaneously) tinnitus and neck complaints had significantly lower TFI-scores after treatment (p = 0.001) and follow-up (p = 0.03). The presence of this co-variation and a combination of low pitched tinnitus and increasing tinnitus during inadequate cervical spine postures are prognostic indicators for a decrease in TFI-scores after cervical physical therapy (adjusted R2= 0.357).
  
  
  
  Patients who experience a decrease in tinnitus annoyance from cervical physical therapy are those with co-varying tinnitus and neck complaints and those with a combination of low-pitched tinnitus and increasing tinnitus during inadequate cervical spine postures.
authors.affiliation: 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.forename: S
authors.initials: S
authors.lastname: Michiels
authors.affiliation: 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.forename: P
authors.initials: P
authors.lastname: Van de Heyning
authors.affiliation: 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.forename: S
authors.initials: S
authors.lastname: Truijen
authors.affiliation: 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.forename: A
authors.initials: A
authors.lastname: Hallemans
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: De Hertogh
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D011379:Prognosis; D012720:Severity of Illness Index; D013003:Somatosensory Cortex / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000503:physiopathology* / Q000628:therapy*
keywords: Cervical spine; Prognostic indicators; Somatic tinnitus