A randomized controlled trial began enrolling participants in March 2025 and is expected to continue through December 2026 to assess the short-term effects of whole-spine manual therapy in adults with cervical vertigo.
Researchers will compare three approaches: synergistic manual therapy involving both cervical and thoracolumbar manipulation, cervical-only manual therapy, and no treatment.
The study includes 138 participants between 18 and 75 years old who meet diagnostic criteria for cervical vertigo. Participants are randomly assigned in a 1:1:1 ratio to one of the three groups. The trial includes a 2-week treatment period and a 3-month follow-up, with assessments at baseline and at 2, 6, 10, and 14 weeks.
The primary outcome is the change in vertigo severity, measured by the Dizziness Handicap Inventory. This scale has a total score of 0 to 100, with higher scores indicating more severe symptoms. Researchers, led by Chao Lu of the Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province, China, and colleagues, calculated that 42 patients per group are needed to detect a 12-point difference in Dizziness Handicap Inventory scores between groups, assuming a standard deviation of 17, with 90% power and a two-sided α level of 0.025. Each group will include 46 participants to accommodate an anticipated 10% dropout rate.
Secondary outcomes include changes in vertebrobasilar artery blood flow velocity, Essex-Symonds Cervical Vertebral Index Scale scores, and 36-item Short-Form Health Survey scores. Blood flow velocity will be measured by transcranial Doppler ultrasound. The Essex-Symonds Cervical Vertebral Index Scale evaluates vertigo, pain, and psychosocial impact, while the 36-item Short-Form Health Survey assesses health-related quality of life across eight dimensions, with a total score range of 0 to 800.
Participants in the synergistic manual therapy group will receive cervical manipulations along with thoracic and lumbar adjustments. Those in the cervical-only group will receive soft tissue manipulation, cervical traction, and high-velocity, low-amplitude joint techniques. Each patient in the treatment groups will receive therapy three times per week for 2 weeks. Participants in the control group will not receive treatment during the study but will be offered six sessions after the trial concludes.
Safety will be monitored throughout. Adverse events such as changes in heart rate, blood pressure, shortness of breath, or fainting will be recorded. Serious adverse events, including life-threatening conditions, disability, or hospitalization, will be reviewed by an independent data monitoring committee.
Blinding applies to outcome assessors and statisticians due to the nature of the intervention.
The study aims to provide evidence on whether whole-spine manual therapy is more effective than cervical-only therapy or no treatment in improving symptoms of cervical vertigo.
The authors reported no conflicts of interest.