Sustained Natural Apophyseal Glides With and Without Facilitated Positional Release Technique in Cervicogenic Dizziness
2026年6月8日 更新者：Riphah International University
Effects of Sustained Natural Apophyseal Glides With and Without Facilitated Positional Release Technique on Pain, Dizziness, Range of Motion, and Functional Status Among Patients With Cervicogenic Dizziness
Cervicogenic Dizziness is characterized by non-rotatory dizziness and a sense of disequilibrium associated with neck pain, stiffness, and decreased range of motion.
It arises from the abnormal afferent inputs from the upper cervical spine.
Patients may experience lightheadedness and neck pain triggered by neck movements, leading to functional limitations.
The present study aims to compare the effects of sustained natural apophyseal glides only and in combination with the facilitated positional release technique on pain intensity, severity of dizziness, range of motion, and functional status among patients with cervicogenic dizziness
研究概览
详细说明
A double-blinded randomized clinical trial will be conducted at the Government Teaching Hospital, Shahdara, Lahore.
A total of 42 patients (21 in each group) will be enrolled in this study, and a non-probability, purposive sampling technique will be used for data collection.
Patients will be allocated to Group A and Group B after randomization using an online randomization tool.
After obtaining informed consent, Group A will receive treatment of SNAGs along with FPRT, while Group B will receive SNAGs only, three times a week for four weeks.
Outcome measures will include the Numeric Pain Rating Scale (NPRS) for pain, the Dizziness Handicap Inventory Scale (DHI) for dizziness, a goniometer for range of motion, and the Neck Disability Index (NDI) for functional status.
Assessment will be conducted on the first day and after four weeks of treatment.
Data will be analyzed using SPSS version 27.
Descriptive statistics will be presented, and the data normality will be assessed using the Shapiro-Wilk test to determine whether a parametric or non-parametric test will be used within or between-group analyses.
研究类型
介入性
注册 (估计的)
42
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习联系方式
- 姓名：Samrood Akram, PhD*
- 电话号码：03324806143
- 邮箱：samrood.akram@riphah.edu.pk
学习地点
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Punjab Province
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Lahore、Punjab Province、巴基斯坦、54920
- Government Teaching Hospital Shahdara
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接触：
- Rahat Afzal, MS-OMPT
- 电话号码：0316 4333853
- 邮箱：rahatafzal850@gmail.com
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-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
接受健康志愿者
不
描述
Inclusion Criteria:
- Age group between 18 and 35 years
- Both male and female participants
- Non-traumatic cervicogenic dizziness with positive cervical torsion test
Exclusion Criteria:
• History of cervical trauma or head/face injury
- Vestibular disorder, i.e., BPPV
- Vertebrobasilar Insufficiency
- Positive Dix-Hallpike Maneuver, Alar Ligament Stress Test, and Vertebral Artery Test
- History of cardiovascular disorders
- Pregnancy
- Diagnosed psychological disorders
- History of cervical spine surgery
- Vertebral Fractures
- Spine disorders such as cervical spondylosis and disc herniation
- Presence of tumor
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：SNAGs along with Functional positional Release Technique
SNAGs (Sustained Natural Apophyseal Glides) and Functional Release Techniques (FRT) are highly effective, non-invasive manual therapy methods used to treat cervicogenic dizziness.
They target the faulty biomechanics, joint restrictions, and muscle hypertonicity in the upper cervical spine (C1-C3) that disrupt cervical proprioception and trigger dizziness.
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SNAG : The therapist will place the palmar aspect of the thumb reinforced by the opposite thumb over the spinous process of C2. The other fingers will apply light pressure on both sides of the face to stabilize the head The therapist will apply anterior glide to C2. Instruct the patient to move his/her neck in the offending direction. FRT: The therapist will palpate the upper trapezius tender point. After palpation, the patient's neck will be brought into a neutral position. The therapist will apply a gentle axial facilitating force (compressive force) through the head towards the feet and will quickly turn the patient's head in side flexion towards the tender point in a position of maximum relaxation. The therapist will maintain this position for 3 to 5 seconds, and the patient's neck will be turned into a neutral position. |
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有源比较器：SNAGs
SNAGs (Sustained Natural Apophyseal Glides) are targeted manual therapy techniques that combine sustained joint glides with active patient movement.
Highly effective for cervicogenic dizziness, they reduce neck pain, improve cervical range of motion, and decrease dizziness by restoring proper upper cervical spine biomechanics and alleviating joint restrictions
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The patient will be seated.
The therapist will stand behind the patient.
The therapist will place the palmar aspect of the thumb reinforced by the opposite thumb over the spinous process of C2.
The other fingers will apply light pressure on both sides of the face to stabilize the head The therapist will apply anterior glide to C2. Instruct the patient to move his/her neck in the offending direction.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Numeric Pain Rating Scale (NPRS) for Pain
大体时间：Upto 4 weeks
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It is the most frequently used pain outcome measure.
It consists of a horizontal 10 cm straight line with 2 marks that have "no pain" (score of 0) and a "worst imaginable pain" (score of 10) at either end of the line.
On this scale, respondents will be asked to rate their level of pain before and after the treatment.
The test-retest reliability of NPRS is (ICC = 0.72), and the construct validity is (AUC = 0.78-0.93).
The Minimal Clinically Important Difference (MCID) is 2.5 points, suggesting a reduction of at least 2.5 points on the NPRS is clinically significant
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Upto 4 weeks
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Dizziness Handicap Inventory Scale (DHI) for dizziness
大体时间：Upto 4 weeks
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The DHI questionnaire consists of 25 items with physical, emotional, and functional subscales.
This scale evaluates the self-perceived handicap from dizziness.
Patients will be asked to answer the questions considering their condition before and after the treatment.
Each item on the questionnaire ranges from 0 to 4. Scores of 16-34 indicate mild, 36-52 indicate moderate, and 54 points or more represent severe handicap.
The test-retest reliability of DHI is high (r = 0.92 to 0.97) and high internal consistency (alpha = 0.72 to 0.89).
The MCID for DHI is reported as ≥ 10 points
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Upto 4 weeks
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Universal Goniometer for ROM
大体时间：Upto 4 weeks
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It was used to measure the cervical range of motion.
It is a less expensive and easy-to-use instrument.
It has two arms, one of which is stationary and the other is a movable arm.
The center of the UG is the fulcrum.
The test-retest reliability of the goniometer is excellent (ICC ≥ 0.98), and the inter-rater reliability is (ICC ≥ 0.94).
The Minimal Detectable Change (MDC ≤ 5.23% (≈ 2-3°) is considered a true change in ROM
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Upto 4 weeks
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Neck Disability Index (NDI) for disability
大体时间：Upto 4 weeks
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The NDI questionnaire consists of 10 items designed to measure neck-specific disability.
Out of 10 items, 7 correlated with daily living activities, 2 with pain, and 1 with concentration.
Each item on the questionnaire ranges from 0 to 5, with higher scores indicating greater disability.
The test-retest reliability of NDI is high (r = 0.89), and the Construct validity is (r ≥ 0.70).
The MCID for NDI is >5 Points, meaning a reduction of 5 or more points is considered clinically meaningful
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Upto 4 weeks
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Rahat Afzal, MS-OMPT、Governement Teaching Hospital Shahdara Lahore.
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Li Y, Peng B. Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo. Pain Physician. 2015 Jul-Aug;18(4):E583-95.
- 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. doi: 10.2519/jospt.2000.30.12.755.
- Sung YH. Suboccipital Muscles, Forward Head Posture, and Cervicogenic Dizziness. Medicina (Kaunas). 2022 Dec 5;58(12):1791. doi: 10.3390/medicina58121791.
- Luscher M, Theilgaard S, Edholm B. Prevalence and characteristics of diagnostic groups amongst 1034 patients seen in ENT practices for dizziness. J Laryngol Otol. 2014 Feb;128(2):128-33. doi: 10.1017/S0022215114000188. Epub 2014 Feb 13.
- Vural M, Karan A, Albayrak Gezer I, Caliskan A, Atar S, Yildiz Aydin F, Coskun Benlidayi I, Goksen A, Koldas Dogan S, Karacan G, Erdem R, Eda Kurt E, Kesiktas FN, Aydin T, Sahin N, Aydin Z, Ordahan B, Turkoglu G, Resorlu H, Doner D, Yilmaz F, Bertan H, Dulgeroglu D, Karaahmet OZ, Sonel Tur B, Moustafa E, Borman P, Iskender O, Ay S, Kurtaran A, Sirzai H, Evcik D, Capan N, Erhan B, Alptekin HK, Ural HI. Prevalence, etiology, and biopsychosocial risk factors of cervicogenic dizziness in patients with neck pain: A multi-center, cross-sectional study. Turk J Phys Med Rehabil. 2021 Dec 1;67(4):399-408. doi: 10.5606/tftrd.2021.7983. eCollection 2021 Dec.
- Bayraklı BB, Kuzu Ö, ÇElİK C. A Rare Cause of Vertigo: Cervicogenic Dizziness. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi. 2025;28:90-2.
- Moen U, Knapstad MK, Wilhelmsen KT, Goplen FK, Nordahl SHG, Berge JE, Natvig B, Meldrum D, Magnussen LH. Musculoskeletal pain patterns and association between dizziness symptoms and pain in patients with long term dizziness - a cross-sectional study. BMC Musculoskelet Disord. 2023 Mar 8;24(1):173. doi: 10.1186/s12891-023-06279-z.
- Takahashi S. Importance of cervicogenic general dizziness. J Rural Med. 2018 May;13(1):48-56. doi: 10.2185/jrm.2958. Epub 2018 May 29.
- Sung Y-H. Classification of cervicogenic dizziness. Hearing, Balance and Communication. 2023;21(1):10-5.
- Moon KM, Kim J, Seong Y, Suh BC, Kang K, Choe HK, Kim K. Proprioception, the regulator of motor function. BMB Rep. 2021 Aug;54(8):393-402. doi: 10.5483/BMBRep.2021.54.8.052.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (估计的)
2026年5月30日
初级完成 (估计的)
2026年7月30日
研究完成 (估计的)
2026年8月30日
研究注册日期
首次提交
2026年6月8日
首先提交符合 QC 标准的
2026年6月8日
首次发布 (实际的)
2026年6月12日
研究记录更新
最后更新发布 (实际的)
2026年6月12日
上次提交的符合 QC 标准的更新
2026年6月8日
最后验证
2026年6月1日
更多信息
与本研究相关的术语
其他研究编号
- REC/RCR&AHS/25/0122 Aqsa
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不
研究美国 FDA 监管的设备产品
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