POSTURAL AND SYMPTOMATIC IMPROVEMENT AFTER PHYSIOTHERAPY IN PATIENTS WITH DIZZINESS OF SUSPECTED CERVICAL ORIGIN

Objective: To assess postural performance in patients with dizziness o f suspected cervical origin in whom extracervical causes had been excl uded, and to assess the effects of physiotherapy on postural performan ce and subjective complaints of neck pain and dizziness. Design: Prosp ective, randomized, controlled trial. Setting: Primary care centers an d a tertiary referral center. Patients and Subjects: Of 65 referrals, 43 patients were excluded because extracervical etiology was suspected . Of the remaining 22 patients, 17 completed the study (15 women, 2 me n, (x) over bar age 37 yr, range 26-49). The controls were 17 healthy subjects (15 women, 2 men, (x) over bar age 36 yr, range 25-55). Inter vention: Physiotherapy based on analysis of symptoms and findings, and aimed to seduce cervical discomfort. Patients were randomized either to receive immediate physiotherapy (n = 9), or to wait 2 months, under go repeat measurements, and then receive physiotherapy (n = 8). Main O utcome Measures: Posturography, measuring velocity and variance of vib ration-induced body sway and variance of galvanically induced body swa y. Subjective intensity of neck pain (Visual Analog Scale ratings, 0-1 00), intensity and frequency of dizziness (subjective score 0-4). Resu lts: The patients manifested significantly poorer postural performance than did healthy subjects (.05 > p > .0001). Physiotherapy significan tly reduced neck pain and intensity and the frequency of dizziness (p < .01), and significantly improved postural performance (.05 > p > .00 07). Conclusions: Patients with dizziness of suspected cervical origin are characterized by impaired postural performance. Physiotherapy red uces neck pain and dizziness and improves postural performance. Neck d isorders should be considered when assessing patients complaining of d izziness, but alternative diagnoses are common.