Therapeutic patient education and exercise therapy in patients with cervicogenic dizziness: a prospective case series clinical study

Abstract

The purpose of this study was to evaluate the effectiveness of a treatment for patients with cervicogenic dizziness that consisted of therapeutic education and exercises. The Dizziness Handicap Inventory and Neck Disability Index were used. Secondary outcomes included range of motion, postural control, and psychological variables. Seven patients (two males and five females) aged 38.43±14.10 with cervicogenic dizziness were included. All the participants received eight treatment sessions. The treatment was performed twice a week during a four weeks period. Outcome measures included a questionnaire (demographic data, body chart, and questions about pain) and self-reported disability, pain, and psychological variables. Subjects were examined for cervical range of motion and postural control. All of these variables were assessed pre- and postintervention. Participants received eight sessions of therapeutic education patient and therapeutic exercise. The majority of participants showed an improvement in catastrophism (mean change, 11.57±7.13; 95% confidence interval [CI], 4.96-18.17; d=1.60), neck disability (mean change, 5.14±2.27.28; 95% CI, 3.04-7.24; d=1.32), and dizziness disability (mean change, 9.71±6.96; 95% CI, 3.26-16.15; d=1.01). Patients also showed improved range of motion in the right and left side. Therapeutic patient education in combination with therapeutic exercise was an effective treatment. Future research should investigate the efficacy of therapeutic patient education and exercise with larger sample sizes of patients with cervicogenic dizziness.

Keywords: Cervicogenic dizziness; Dizziness handicap inventory; Education; Neck disability index; Therapeutic exercise.

1) Flexion: Try to touch your chest with your chin. This exercise should be done for 4 days/week and the frequency is 10 times ×3 sets.

2) Rotation: Turn your head to the right and left making a stop in the middle of the range. This exercise should be done for 4 days/week and the frequency is 3 sets ×10 times.

3) Lateral flexion: Tilt your head to the right and to the left making a stop in the middle of the range keeping your shoulders down. This exercise should be done for 4 days/week and the frequency is 3 sets ×10 times.

1) Crane-cervical flexion: Put an elastic band on the occipital bone and hold it with your hands maintaining your arms in a 90˚ angle. 2) Bring your chin forward. Then bring it back against the band.

1) Set a fixed point in front of your eyes. Turn your head to both sides keeping your eyes on your thumb.

2) Set a fixed point in front of your eyes. Close your eyes. Turn your head with eyes closed and try to put your head in the initial position. Open your eyes and check it.

3) Extend your arm to the right side and try to turn your head to the front keeping your gaze looking at your thumb. Then repeat the exercise to the other side using your left arm.

4) Extend your arms in front you with your thumbs in front of your eyes. Your thumbs should be separated by 7–10 cm. Then try to look at both thumbs at the same time making your eyes move side to side.

1) Flexion: Put one hand in the front of your head and perform the same force against your hand.

2) Extension: Place your hands behind your head and perform opposing forces.

3) Rotation: Put one of your hands in the side of your forehead and make the force in the direction that will make turn to the left or right your head.

4) Lateral Flexion: Place your hand on your temporalis muscle and make lateral flexion in an isometric exercise making opposing forces.

Trapezium 1: Put your hand on your head as shown in the photograph. Keep your shoulders down. Then bring your head down to stretch trapezium muscle. Then repeat it to the other side.

Trapezium 2: Put your hand on your temporal muscle as shown in the photograph. And bring your head down stretching the muscle.

Sternocleidomastoid: Put your hand on temporal bone, extend your head tilt your head and turn it to the opposite side. Then let your head fall in that position.

Rhomboid: Cross your arms and put both hands separated over the scapulae. You should make opposing forces with both hands keeping your shoulders down.

Pectoralis major: Put your hand on a wall or a door frame, then turn your body guiding your chest to the opposite side.