In 1996, Karlberg, et. al.,  sought to assess postural performance in patients experiencing dizziness suspected to originate from cervical factors. After excluding extracervical causes in 22 patients (15 women, 2 men, mean age 37 years), physiotherapy interventions were employed, and their effects on postural performance and subjective complaints of neck pain and dizziness were evaluated.

The study, conducted at primary care centers and a tertiary referral center, involved a total of 39 participants, with 17 healthy subjects serving as controls (15 women, 2 men, mean age 36 years). Of the 65 initial referrals, 43 were excluded due to suspected extracervical etiology.

Patients were randomized into two groups: one receiving immediate physiotherapy (n = 9), and the other waiting for 2 months before undergoing repeat measurements and then receiving physiotherapy (n = 8). Physiotherapy was tailored based on symptom and finding analysis, with a focus on reducing cervical discomfort.

Posturography was employed to measure the velocity and variance of vibration-induced body sway, along with the variance of galvanically induced body sway. Subjective assessments included the intensity of neck pain measured on a Visual Analog Scale (0-100) and the intensity and frequency of dizziness (subjective score 0-4).

Patients with dizziness of suspected cervical origin exhibited significantly poorer postural performance compared to healthy subjects (p > .0001). Physiotherapy intervention led to a significant reduction in neck pain intensity, as well as in the intensity and frequency of dizziness (p < .01). Moreover, postural performance significantly improved following physiotherapy (p > .0007).

This study highlights the impaired postural performance observed in patients with dizziness of suspected cervical origin. The findings underscore the efficacy of physiotherapy in reducing neck pain and dizziness while concurrently enhancing postural performance. The research suggests that neck disorders should be considered in the assessment of patients presenting with complaints of dizziness, though acknowledging the prevalence of alternative diagnoses in such cases.

Reference: Karlberg, M., Magnusson, M., Eva-Maj, M., Agneta, M., & Moritz, U. (1996). Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Archives of physical medicine and rehabilitation, 77(9), 874-882.