CHERIE: Chuna Manual Therapy for Cervicogenic Dizziness
Study Details
Study Description
Brief Summary
This is a prospective, pragmatic, assessor-blind, randomized controlled trial to explore the effectiveness of an adjuvant Chuna manual therapy (CMT) for cervicogenic dizziness of Dizziness Handicap Inventory (DHI) ≥ 16 at baseline. Participants will be randomized and allocated to either CMT combined with usual care (UC) group or UC group with 1:1 ratio. They will receive 12 sessions of CMT or UC treatment for 6 weeks. UC consists of physical therapy and patients education.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Chuna Manual Therapy (CMT) Chuna manual therapy (CMT), 2 sessions/week, 6 weeks (12 sessions in total) Usual care therapy (UC), 2 sessions/week, 6 weeks (12 sessions in total) Usual care consists of physical therapy and patients education. Physical therapy consists of meridian muscle interferential current electricity (or meridian transcutaneous electricity) and hot pack (or infrared lamp). Patients will be educated about cause and risk factors of cervicogenic dizziness, general neck muscle functions, self-exercising for relieving the symptoms. CMT and UC group will receive the same UC regimen. |
Procedure: Chuna Manual Therapy
Unique manual therapy in traditional Korean medicine
Mandatory techniques for neck part and selective techniques for other part (if necessary)
Selective techniques depends on a patient's condition (judged by traditional Korean medicine doctor)
Procedure: Usual care
Physical therapy based on traditional Korean medicine theory
Electrical stimulation: either Meridian muscle interferential current electricity or Meridian transcutaneous electricity
Heat stimulation: either Hot pack or Infrared lamp
Patient education
Physical and pathological explanation of cervicogenic dizziness
Cause and risk factors of cervicogenic dizziness
Functions of muscles related to cervicogenic dizziness
Home exercising to self-manage cervicogenic dizziness
|
Active Comparator: Usual Care (UC) Usual care therapy (UC), 2 sessions/week, 6 weeks (12 sessions in total) Usual care consists of physical therapy and patients education. Physical therapy consists of meridian muscle interferential current electricity (or meridian transcutaneous electricity) and hot pack (or infrared lamp). Patients will be educated about cause and risk factors of cervicogenic dizziness, general neck muscle functions, self-exercising for relieving the symptoms. CMT and UC group will receive the same UC regimen. |
Procedure: Usual care
Physical therapy based on traditional Korean medicine theory
Electrical stimulation: either Meridian muscle interferential current electricity or Meridian transcutaneous electricity
Heat stimulation: either Hot pack or Infrared lamp
Patient education
Physical and pathological explanation of cervicogenic dizziness
Cause and risk factors of cervicogenic dizziness
Functions of muscles related to cervicogenic dizziness
Home exercising to self-manage cervicogenic dizziness
|
Outcome Measures
Primary Outcome Measures
- Change from baseline Dizziness Handicap Inventory (DHI) score at week 6 [Week 0, Week 6]
Secondary Outcome Measures
- Change from baseline Dizziness Handicap Inventory (DHI) score at week 3 [Week 0, Week 3]
- Changes from baseline Mean Vertigo Score (MVS) at each measurement week [Week 0, Week 3, Week 6]
- Changes from baseline Visual Analogue Scale (VAS) score at each measurement week [Week 0, Week 3, Week 6]
- Changes from baseline Frequency of Dizziness score at each measurement week [Week 0, Week 3, Week 6]
- Changes from baseline Pain Intensity Numerical Rating Scale (PI-NRS) score at each measurement week [Week 0, Week 3, Week 6]
- Changes from baseline Neck Disability Index (NDI) score at each measurement week [Week 0, Week 3, Week 6]
- Changes from baseline Cervical Range of Motion (CROM) value at each measurement week [Week 0, Week 3, Week 6]
- Global Perceived Effect (GPE) score at each measurement week [Week 6]
- Changes from baseline Korean version of Perceived Stress Scale (K-PSS) score at each measurement week [Week 0, Week 3, Week 6]
- Changes from baseline EuroQoL Five Dimensions Questionnaire (EQ-5D) score at each measurement week [Week 0, Week 3, Week 6]
Other Outcome Measures
- New Blinding Index (New BI) [Week 6]
Eligibility Criteria
Criteria
Inclusion Criteria:
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male or female aged between 20 and 70
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neck pain and/or stiffness with dizziness, which is related to movement or positioning of cervical spine
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recurring symptom of dizziness over 1 month or more
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Dizziness Handicap Inventory ≥ 16 at baseline
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Informed consent
Exclusion Criteria:
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dizziness induced by vestibular disorders (e.g., benign paroxysmal positional vertigo, peripheral vestibulopathy, Meniere disease, vestibular neuronitis)
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dizziness induced by central nervous system (CNS) disorders (e.g., cerebellar ataxia,cerebellum infarction/hemorrhage, demyelination, vertebrobasilar insufficiency, seizure, increased intracranial pressure, Parkinson's disease, migraines)
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dizziness induced by cardiovascular disorders (e.g., arrhythmia, heart valvular disease, anemia, orthostatic hypotension, coronary artery disease)
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dizziness induced by active or uncontrolled disease (e.g., uncontrolled diabetes mellitus, hypertension, respiratory or endocrinological disorders)
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dizziness induced by side effects of medications
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severe chronic or terminal diseases (malignant cancer, tuberculosis, etc.)
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chronic psychiatric diseases under treatment (epilepsy, depression, panic disorder, etc.)
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conditions where CMT are forbidden (spinal tumor, acute fracture, infectious spondylopathy, congenital malformations of spine, operation history of spine within 3 months, progressive neurological damage, severe neurological symptoms, spinal fixation devices, syringomyelia, hydrocephaly)
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Treatment history within 1 week for cervicogenic dizziness (NSAIDs, steroid, herbal drug, acupuncture, manual therapy)
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Women of (suspected) pregnancy or breast-feeding
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Suspicion of alcohol and/or drug abuse
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Participation in another clinical study within 1 month
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Difficulty in communicating with the investigators
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Other reasons for ineligibility of participation
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Kyung Hee University Korean Medicine Hospital | Seoul | Special Seoul City | Korea, Republic of | 02447 |
2 | Kyung Hee University Korean Medicine Hospital at Gangdong | Seoul | Korea, Republic of | 05278 |
Sponsors and Collaborators
- Kyunghee University
Investigators
- Principal Investigator: Euiju Lee, Ph.D., Kyunghee University
Study Documents (Full-Text)
None provided.More Information
Publications
- Heikkilä H, Johansson M, Wenngren BI. Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study. Man Ther. 2000 Aug;5(3):151-7.
- Karlberg M, Magnusson M, Malmström EM, Melander A, Moritz U. Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Arch Phys Med Rehabil. 1996 Sep;77(9):874-82.
- Li Y, Peng B. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician. 2015 Jul-Aug;18(4):E583-95. Review.
- Minguez-Zuazo A, Grande-Alonso M, Saiz BM, La Touche R, Lara SL. Therapeutic patient education and exercise therapy in patients with cervicogenic dizziness: a prospective case series clinical study. J Exerc Rehabil. 2016 Jun 30;12(3):216-25. doi: 10.12965/jer.1632564.282. eCollection 2016 Jun.
- Reid SA, Callister R, Snodgrass SJ, Katekar MG, Rivett DA. Manual therapy for cervicogenic dizziness: Long-term outcomes of a randomised trial. Man Ther. 2015 Feb;20(1):148-56. doi: 10.1016/j.math.2014.08.003. Epub 2014 Aug 27.
- Reid SA, Rivett DA, Katekar MG, Callister R. Efficacy of manual therapy treatments for people with cervicogenic dizziness and pain: protocol of a randomised controlled trial. BMC Musculoskelet Disord. 2012 Oct 18;13:201. doi: 10.1186/1471-2474-13-201.
- Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther. 2005 Feb;10(1):4-13. Review.
- RYAN GM, COPE S. Cervical vertigo. Lancet. 1955 Dec 31;269(6905):1355-8.
- Wrisley DM, Sparto PJ, Whitney SL, Furman JM. Cervicogenic dizziness: a review of diagnosis and treatment. J Orthop Sports Phys Ther. 2000 Dec;30(12):755-66. Review.
- Yacovino DA, Hain TC. Clinical characteristics of cervicogenic-related dizziness and vertigo. Semin Neurol. 2013 Jul;33(3):244-55. doi: 10.1055/s-0033-1354592. Epub 2013 Sep 21. Review.
- HB16C0010-CMT