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NCT Number: NCT07062809

Comparing the Effects of Sub-Occipital Myofascial Release With and Without SNAG on People With Cervicogenic Dizziness.

Cervicogenic dizziness is defined as a sensation of rotation, resulting from an alteration of the neck proprioceptive afferents of the upper cervical spine.Sub-occipital Release, a type of Myofascial Release (MFR) is a form of manual therapy technique which can be used for the treatment of cervicogenic dizziness. Sub-occipital muscles, dura matter and C2 vertebrae are connected to each other through the fascia. Sustained natural apophyseal glides (SNAGs) are also an effective treatment for cervicogenic dizziness. This study aim to determine Comparative Effect of Sub-Occipital Myofascial release with and without Sustained Natural Apophyseal Glide among patients with Cervicogenic Dizziness.

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Key information

Conditions

Dizziness Brain Diseases Central Nervous System Diseases Cervicogenic Headache Headache Disorders Headache Disorders, Secondary Nervous System Diseases Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Post-Traumatic Headache Sensation Disorders Signs and Symptoms

Age range

22 year–54 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

This study will be a randomized controlled trial and will be conducted in Hameed Latif Teaching Hospital and National hospital & Medical Center. Non-probability consecutive sampling will be used to collect the data. Subjects with age group between 22 to 54 years old will be taken. Data will be collected from the patients having present complaint of cervicogenic dizziness. Group A and Group B were the two randomly selected groups into which the participants were divided. Baseline assessment of pain, dizziness and Headache was taken using Visual Analogue Scale (VAS), Dizziness Handicap Inventory (DHI) and Numeric Pain Rate Scale (NPRS) respectively, before the start of treatment by an assessor. Subjects will be selected on the basis of inclusion and exclusion criteria. Both the Groups will receive Hot Pack ,TENS , Ultrasound ,and also will receive Sternocleidomastoid, Trapezius, Scalene, and Pectoralis minor muscle stretching exercises, while Group A will receive Sub-Occipital Myofascial Release and Sustained Natural Apophyseal Glide (SNAG), and Group B will receive Sub Occipital Myofascial Release. Short term effects would be assessed after treatment for 3 sessions per week on alternate days for 4 weeks. Data analysis will be done by SPSS version 25.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Cervicogenic dizziness patients both male and female.
  • Age group between 22 to 54 Years old.
  • Passive Accessory Assessment of the UCS (C0-1, C1-2, C2-3).
  • Dizziness related to either movements or positions of the cervical spine, or occurring with a stiff or painful neck.
  • Symptoms > 3 months.
  • Moderate disability score on the Dizziness Handicap Inventory (DHI) [31-60 points] .

Exclusion criteria

  • Conditions for which manual therapy is contraindicated
  • Traumatic brain injury
  • Previous surgery to the upper cervical spine and marked cervical spine disc protrusion
  • By neurologist .Vestibular disorders (e.g. Benign Paroxysmal Positional Vertigo, Meniere's disease, peripheral vestibulopathy)
  • CNS disorder (e.g.cerebellar ataxia, stroke, demyelination)
  • Migraine associated vertigo
  • Psychogenic dizziness
  • Cardiovascular disorders

Treatment and study plan

Sub Occipital Myofascial release and (SNAGS).

Other

The patient will instruct to be seated then will turned his head toward direction that will cause his dizziness. when subject will turn his head, The manual therapist will perform a constant PA glide (using his thumbs one over the other) to upper cervical C1 or C2 vertebra (Oriented toward patient's eyeballs). If flexion or extension movement will provoke the dizziness, an anterior glide will apply to the C2 spinous process. If rotation will provoke dizziness, then an anterior glide will be applied to the C1 transverse process.

Sub Occipital Myofascial release.

Other

When using the technique, the patient will be in Upward-facing position with their head fully aided on the therapist's hands. The therapist will put three middle fingers simply inferior to the nuchal line, raise the tips of the fingers in the direction of the ceiling, and then simply pull them upward.

Primary outcomes

  1. Visual Analogue Scale (VAS)

    Time frame: 4 weeks

    The dizziness intensity was registered with a VAS, a valid and reliable tool for measuring dizziness intensity (reliability test-retest of this VAS is r = 0.85-0.96) .A continuous vertical line of 100 mm was anchored by two verbal descriptors ("no dizziness" and "worst imaginable dizziness"), and each end of the line had a mark; the subjects had to mark on the line the worst perceived dizziness since the last appointment (wVAS). Although it is a subjective and individual scale of the patient, it allows us to register the intensity of dizziness quickly, and its use in the clinic is widespread.

Secondary outcomes

  1. Dizziness Handicap Inventory (DHI)

    Time frame: 4 weeks

    The impact of dizziness on quality of life is often assessed by the Dizziness Handicap Inventory (DHI). The DHI contains 25 items, and a total score (0-100 points) is obtained by summing ordinal scale responses, higher scores indicating more severe handicap. The scale was developed to capture various sub-domains of self-perceived handicap and comprises 7 physical, 9 functional, and 9 emotional questions

Other outcomes

  1. Numerical Pain Rating Scale (NPRS)

    Time frame: 4 weeks

    This scale will be used to measure the patient's level of pain. The numbers on this scale go from 0 to 10. "No pain" is denoted by a score of 0, and "worst pain" by a score of 10. High test-retest reliability has been demonstrated using NPRS (r = 0.96 and 0.95, respectively)

Study contacts

Contact information is provided by the study sponsor or research team.

Muzna Munir, PHD scholar

CONTACT

[email protected]

03344265125

Naseer Ahmad Naseer Mehravi, MS student

CONTACT

[email protected]

03037272342

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Comparative Effects of Sub-Occipital Myofascial Release With and Without Sustained Natural Apophyseal Glide Among Patients With Cervicogenic Dizziness.

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jul 14, 2025
Registry last updated
Jul 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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