Abstract
BackgroundTraumatic cervicogenic dizziness is dizziness that is temporally associated with neck pain and injury after other causes of dizziness have been excluded. It can lead to activity limitations and participation restrictions that may include lost duty or work days. The objective of this systematic review is to determine which interventions are most effective in decreasing dizziness or vertigo and neck pain in military-aged adults with traumatic cervicogenic dizziness.MethodsThe literature will be systematically searched using the following online databases: MEDLINE, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, CENTRAL, Cochrane Methodology Register), CINAHL, SCOPUS, Web of Science, and J-STAGE. The review will include randomized controlled trials (RCTs), including cluster RCTs and controlled (non-randomized) clinical trials or cluster trials, and observational studies (including prospective and retrospective comparative cohort and case–control or nested case–control studies) and determine the effectiveness of physical therapy interventions for the treatment of traumatic cervicogenic dizziness in military-aged adults. Assessment of methodological quality will be performed by two independent, blinded reviewers using the PEDro scale. The level of evidence will be determined using the GRADE scale. The primary outcome measures will be change in dizziness and neck pain and disability from baseline to the last available follow-up, measured using the Dizziness Handicap Inventory and Neck Disability Index. Other relevant outcome measures will include self-reported change in symptoms, time to return to duty or work, and quality of life.DiscussionThis systematic review will identify, evaluate, and integrate the evidence on the effectiveness of physical therapy interventions for cervicogenic dizziness in a military-aged population. We anticipate our findings may inform individual treatment and future research. Clinical recommendations generated from this systematic review may inform military physical therapy treatment of individuals with cervicogenic dizziness.Systematic review registrationIn accordance with the guidelines, our systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 21 January 2020 (registration number CRD42020150853). In the event of protocol amendments, the date of each amendment will be accompanied by a description of the change and the rationale.
Highlights
Traumatic cervicogenic dizziness is dizziness that is temporally associated with neck pain and injury after other causes of dizziness have been excluded
Manual therapy is the primary intervention utilized in past systematic reviews for the management of cervicogenic dizziness (CGD); this study aims to include a variety of interventional approaches such as education, exercise, manual therapy, vestibular rehabilitation, and modalities for the management of CGD
The objective of this systematic review is to determine which interventions are most effective in decreasing dizziness or vertigo and neck pain in military-aged adults with traumatic CGD
Summary
Traumatic cervicogenic dizziness is dizziness that is temporally associated with neck pain and injury after other causes of dizziness have been excluded. Defined as disorientation that produces a disturbed postural awareness, dizziness has been attributed to neurologic, vestibular, psychosomatic, and cervical spine dysfunction [2, 3]. Of these etiologies, this systematic review is concerned with dizziness related to cervical spine dysfunction. First defined by Ryan and Cope in 1955, dizziness originating from the cervical spine, or cervicogenic dizziness (CGD), is a symptom that is produced by changes in the position of the neck [4]. A retrospective study of active-duty military patients treated for dizziness after mild traumatic brain injury found a subset of patients that benefited from specific cervical spine proprioceptive training [7]
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