S.A. Reid, BAppSc(Phty), GradDipManipTher, MMedSc(Phty), BPharm, School of Physiotherapy, Australian Catholic University, PO Box 968, North Sydney, New South Wales, 2059, Australia.
Phys Ther. 2014 Apr;94(4):466-76. doi: 10.2522/ptj.20120483. Epub 2013 Dec 12.
There is short-term evidence for treatment of cervicogenic dizziness with Mulligan sustained natural apophyseal glides (SNAGs) but no evidence for treatment with Maitland mobilizations.
The purpose of this study was to compare the effectiveness of SNAGs and Maitland mobilizations for cervicogenic dizziness.
A double-blind, parallel-arm randomized controlled trial was conducted.
The study was conducted at a university in Newcastle, Australia.
Eighty-six people with cervicogenic dizziness were the study participants.
Included participants were randomly allocated to receive 1 of 3 interventions: Mulligan SNAGs (including self-administered SNAGs), Maitland mobilizations plus range-of-motion exercises, or placebo.
The primary outcome measure was intensity of dizziness. Other outcome measures were: frequency of dizziness, the Dizziness Handicap Inventory (DHI), intensity of pain, and global perceived effect (GPE).
Both manual therapy groups had reduced dizziness intensity and frequency posttreatment and at 12 weeks compared with baseline. There was no change in the placebo group. Both manual therapy groups had less dizziness intensity posttreatment (SNAGs: mean difference=-20.7, 95% confidence interval [95% CI]=-33.6, -7.7; mobilizations: mean difference=-15.2, 95% CI=-27.9, -2.4) and at 12 weeks (SNAGs: mean difference=-18.4, 95% CI=-31.3, -5.4; mobilizations: mean difference=-14.4, 95% CI=-27.4, -1.5) compared with the placebo group. Compared with the placebo group, both the SNAG and Maitland mobilization groups had less frequency of dizziness at 12 weeks. There were no differences between the 2 manual therapy interventions for these dizziness measures. For DHI and pain, all 3 groups improved posttreatment and at 12 weeks. Both manual therapy groups reported a higher GPE compared with the placebo group. There were no treatment-related adverse effects lasting longer than 24 hours.
The therapist performing the interventions was not blind to group allocation.
Both SNAGs and Maitland mobilizations provide comparable immediate and sustained (12 weeks) reductions in intensity and frequency of chronic cervicogenic dizziness.
有短期证据表明，Mulligan 持续自然关节突滑动（SNAGs）可治疗颈源性头晕，但没有证据表明 Maitland 松动可以治疗颈源性头晕。
本研究旨在比较 SNAGs 和 Maitland 松动治疗颈源性头晕的效果。
双盲、平行臂随机对照试验。
研究在澳大利亚纽卡斯尔的一所大学进行。
86 名颈源性头晕患者为研究参与者。
纳入的参与者被随机分配接受 3 种干预措施之一：Mulligan SNAGs（包括自我实施的 SNAGs）、Maitland 松动加活动范围练习或安慰剂。
主要结局指标为头晕强度。其他结局指标包括：头晕频率、头晕障碍量表（DHI）、疼痛强度和整体感知效果（GPE）。
与基线相比，两组手法治疗组在治疗后和 12 周时头晕强度和频率均降低。安慰剂组没有变化。两组手法治疗组治疗后头晕强度均降低（SNAGs：平均差异=-20.7，95%置信区间[95%CI]=-33.6，-7.7；松动：平均差异=-15.2，95%CI=-27.9，-2.4）和 12 周（SNAGs：平均差异=-18.4，95%CI=-31.3，-5.4；松动：平均差异=-14.4，95%CI=-27.4，-1.5）与安慰剂组相比。与安慰剂组相比，SNAG 和 Maitland 松动组在 12 周时头晕频率均降低。这两种手法治疗方法在这些头晕测量指标上没有差异。对于 DHI 和疼痛，三组在治疗后和 12 周时均有改善。与安慰剂组相比，两组手法治疗组的 GPE 均较高。没有持续超过 24 小时的与治疗相关的不良反应。
进行干预的治疗师对分组分配不知情。
SNAGs 和 Maitland 松动均可即刻和持续（12 周）降低慢性颈源性头晕的强度和频率。
