COMPARISON OF MANUAL THERAPY, TINNITUS RETRAINING THERAPY (TINNITUS)

July 31, 2026 updated by: Dr. Emine Metin, phd, Suleyman Demirel University

COMPARISON OF MANUAL THERAPY, TINNITUS RETRAINING THERAPY, AND COMBINED THERAPY IN PATIENTS WITH SOMATOSENSORY TINNITUS: A THREE-ARM RANDOMİZED CONTROLLED TRIAL

This randomized controlled trial aims to compare the effectiveness of Manual Therapy (MT), Tinnitus Retraining Therapy (TRT), and their combination in adults with somatosensory tinnitus. Sixty-five participants will be randomly assigned to one of three parallel groups. Primary and secondary outcomes include tinnitus severity, tinnitus-related disability, neck disability, cervical range of motion, audiological measures, pressure pain threshold, anxiety, depression, and quality of life. Outcomes will be assessed before treatment and immediately after the six-week intervention period.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

65

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18 to 65 years.
  • Diagnosis of chronic subjective somatosensory tinnitus persisting for at least 3 months.
  • Tinnitus that can be modulated by head, neck, jaw, or temporomandibular movements and/or cervical muscle palpation.
  • Ability to understand the study procedures and provide written informed consent.
  • Willingness to comply with the treatment protocol and attend all scheduled assessment and treatment sessions.
  • Normal middle ear function as confirmed by immittance (tympanometry) testing.

Exclusion Criteria:

Objective or pulsatile tinnitus.

  • Tinnitus duration of less than 3 months.
  • Diagnosis of Ménière's disease, otosclerosis, vestibular schwannoma (acoustic neuroma), or other retrocochlear pathology.
  • Active middle ear disease or abnormal immittance (tympanometry) findings.
  • History of cervical spine surgery or severe cervical trauma.
  • Presence of cervical spine fracture, instability, malignancy, inflammatory rheumatic disease, or other contraindications to manual therapy.
  • Previous temporomandibular joint surgery or severe temporomandibular disorders requiring surgical treatment.
  • Current participation in another clinical trial.
  • Receipt of manual therapy, Tinnitus Retraining Therapy (TRT), or other tinnitus-specific rehabilitation within the previous 3 months.
  • Severe neurological or psychiatric disorders that could interfere with participation or outcome assessment.
  • Pregnancy.

Inability to understand study procedures, provide informed consent, or comply with the intervention schedule.

-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Manual Therapy,
Participants assigned to this group will receive manual therapy targeting the cervical spine and temporomandibular region. Treatment will include soft tissue mobilization, trigger point release, joint mobilization, stretching, and other manual techniques as indicated. Participants will receive 12 treatment sessions over a 6-week period.
Behavioral: Manuel therapy
This study is a prospective, single-center, assessor-blinded, three-arm, parallel-group randomized controlled trial designed to compare the effectiveness of Tinnitus Retraining Therapy (TRT), Manual Therapy (MT), and the combination of TRT plus MT in adults with somatosensory tinnitus. Participants will be randomly assigned in a 1:1:1 ratio using a computer-generated block randomization sequence. Allocation concealment will be ensured using the sequence.
Other Names:
  • procedure
Active Comparator: Tinnitus Retraining Therapy
Participants assigned to this group will receive Tinnitus Retraining Therapy (TRT), consisting of directive counseling and individualized sound therapy. The intervention will be delivered over 12 sessions during a 6-week treatment period.
Behavioral: Manuel therapy
This study is a prospective, single-center, assessor-blinded, three-arm, parallel-group randomized controlled trial designed to compare the effectiveness of Tinnitus Retraining Therapy (TRT), Manual Therapy (MT), and the combination of TRT plus MT in adults with somatosensory tinnitus. Participants will be randomly assigned in a 1:1:1 ratio using a computer-generated block randomization sequence. Allocation concealment will be ensured using the sequence.
Other Names:
  • procedure
Active Comparator: Combined Manual Therapy and Tinnitus Retraining Therapy
Participants assigned to this group will receive both manual therapy and Tinnitus Retraining Therapy (TRT). Manual therapy will target the cervical spine and temporomandibular region, while TRT will consist of directive counseling and individualized sound therapy. Participants will receive 12 treatment sessions over a 6-week period.
Behavioral: Manuel therapy
This study is a prospective, single-center, assessor-blinded, three-arm, parallel-group randomized controlled trial designed to compare the effectiveness of Tinnitus Retraining Therapy (TRT), Manual Therapy (MT), and the combination of TRT plus MT in adults with somatosensory tinnitus. Participants will be randomly assigned in a 1:1:1 ratio using a computer-generated block randomization sequence. Allocation concealment will be ensured using the sequence.
Other Names:
  • procedure

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The TPFQ is a validated patient-reported questionnaire
Time Frame: Baseline and Week 6 (end of treatment)
The TPFQ is a validated patient-reported questionnaire used to assess tinnitus severity and its functional impact. Higher scores indicate greater tinnitus-related impairm
Baseline and Week 6 (end of treatment)
The THI is a validated questionnaire
Time Frame: Baseline and Week 6
The THI is a validated questionnaire assessing the degree of tinnitus-related handicap. Higher scores indicate greater tinnitus-re
Baseline and Week 6

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Suleyman Demirel University

Investigators

  • Study Director: ziya YILDIZ, Isparta University of Applied Sciences

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • 1. Michiels S, Van de Heyning P, Truijen S, Hallemans A, De Hertogh W. Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus? Man Ther. 2016;26:125-131. 2. Kleinjung T, Peter N, Schecklmann M, Langguth B. The current state of tinnitus diagnosis and treatment: a multidisciplinary expert perspective. JARO: Journal of the Association for Research in Otolaryngology. 2024;25(5):413. 3. Kinne B, Bays L, Fahlen K, Owens J. Somatic tinnitus and manual therapy: a systematic review. J Phy Med Rehab. 2018;2:111. 4. Atan D, Atan T, Çakır Ağca BN, Güzelküçük Ü. Effectiveness of manual therapy in the treatment of somatic tinnitus: a randomized controlled trial. Physiother Theory Pract. 2026:1-11. 5. Michiels S, Wölflick S, Simões J, Schlee W. Exploring app-based physiotherapy for somatic tinnitus: results from a pilot study. Journal of Clinical Medicine. 2024;13(23):7203. 6. Bökel A, Fobbe A, Lesinski-Schiedat A, Sturm C. Exploring the Effects of Manual Therapy on Somatosensory Tinnitus and Dizziness: A Randomized Controlled Trial. Journal of Clinical Medicine. 2025;14(13):4579. 7. Sanchez TG, Rocha CB. Diagnosis and management of somatosensory tinnitus. Clinics. 2011;66(6):1089-1094. 8. Phillips JS, McFerran D. Tinnitus retraining therapy (TRT) for tinnitus. The Cochrane database of systematic reviews. 2010;2010(3):CD007330. 9. Ostermann K, Lurquin P, Horoi M, Cotton P, Herve V, Thill M. Somatic tinnitus prevalence and treatment with tinnitus retraining therapy. B-ENT. 2016;12(1):59-65. 10. Michiels S, De Hertogh W, Truijen S, Van de Heyning P. Physical therapy treatment in patients suffering from cervicogenic somatic tinnitus: study protocol for a randomized controlled trial. Trials. 2014;15(1):297. 11. Öcal FCA, Bozkurt HK, Ünlü CE, Tyler R, Satar B. Validity of the Turkish version of the tinnitus primary function questionnaire. Turkish archives of otorhinolaryngology. 2025;62(4):145. 12. Aksoy S, Firat Y, Alpar R

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 12, 2026

Primary Completion (Estimated)

November 30, 2026

Study Completion (Estimated)

December 10, 2026

Study Registration Dates

First Submitted

July 22, 2026

First Submitted That Met QC Criteria

July 31, 2026

First Posted (Actual)

August 3, 2026

Study Record Updates

Last Update Posted (Actual)

August 3, 2026

Last Update Submitted That Met QC Criteria

July 31, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SuleymanDU3
  • ISUBU-E281236 (Other Identifier: Isparta University of Applied Sciences Scientific Research and Publication Ethics Committee)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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