Effects of Vestibular Exercises and Motor Control in Cervicogenic Dizziness
Condition: Cervical Pain
MeSH terms: Dizziness; Neck Pain
Study type: Interventional

Summary: 
      The feelings of imbalance, unsteadiness, and disorientation with cervicogenic dizziness is
      not clear. It has been suggested that a disruption of the normal afferent signals from the
      upper cervical proprioceptors to the vestibular nucleus results in an inaccurate depiction of
      head and neck orientation in space due to highly developed proprioceptive system that allows
      the neuromuscular control of cervical spine and effective use of vital organs in the head
      through unique connections to the vestibular and visual systems. Motor Control Therapeutic
      Exercises and vestibular exercises have been used to increase motor control and reduce pain
      and disability in patients with neck pain.
    

Detailed description: 
      Cervicogenic dizziness is defined as a sensation of instability or disequilibrium that occurs
      with the pain and stiffness in cervical spine and is aggravated by neck movements or
      positions. Dizziness is a common indication in people with cervical spine dysfunction.
      cervicogenic dizziness as "a nonspecific sensation of altered orientation in space and
      disequilibrium originating from abnormal afferent activity from the neck" which is thought to
      be caused by disorders in the upper cervical spine and commonly it is associated with
      cervical stiffness neck pain or headache.

      Motor control can also be defined as the capacity of how the central nervous system produces
      of useful movements that are coordinated and integrated with the rest of the body and the
      environment. Thus, motor control therapeutic exercises (MCTE) are used to improve the
      conditions of patients. Motor Control Therapeutic Exercises have been used to increase motor
      control and reduce pain and disability in patients with neck pain. MCTE comprised of
      cranio-cervical flexor exercise, cranio-cervical extensor exercise, co-contraction of flexors
      and extensors, a synergy exercise for retraining the strength of the deep neck flexors.

      Schenk et al. have published case studies in which they describe the diagnosis, treatment,
      and outcomes of a patient with cervicogenic dizziness co-managed by a vestibular and an
      orthopedic manual physical therapist. They argue that manual therapy combined with vestibular
      rehabilitation may be superior in the treatment of cervicogenic dizziness. Literature states
      that vestibular exercises have been used to increase motor control and reduce pain and
      disability in patients with neck pain.
    

Intervention name(s): Motor Control Group; Vestibular Group
Intervention type(s): Other; Other
Intervention description(s): will received treatment which comprises of therapeutic exercises, During the first 4 weeks, motor control and ROM exercises will be prescribed in order to improve muscular endurance of deep flexors muscles and to improve the ROM of cervical spine in flexion, extension, rotation and side bending and lateral rotation in. These exercises will be performed at a rate of 3 sets and an intensity of 15 repetitions per day .; will receive vestibular exercises which comprises of postural awareness training, balance board exercises, Foveal vision exercises .
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Other