18 research outputs found
Differential postural effects of plantar-flexor muscles fatigue under normal, altered and improved vestibular and neck somatosensory conditions
The aim of the present study was to assess the effects of plantar-flexor
muscles fatigue on postural control during quiet standing under normal, altered
and improved vestibular and neck somatosensory conditions. To address this
objective, young male university students were asked to stand upright as still
as possible with their eyes closed in two conditions of No Fatigue and Fatigue
of the plantar-flexor muscles. In Experiment 1 (n=15), the postural task was
executed in two Neutral head and Head tilted backward postures, recognized to
degrade vestibular and neck somatosensory information. In Experiment 2 (n=15),
the postural task was executed in two conditions of No tactile and Tactile
stimulation of the neck provided by the application of strips of adhesive
bandage to the skin over and around the neck. Centre of foot pressure
displacements were recorded using a force platform. Results showed that (1) the
Fatigue condition yielded increased CoP displacements relative to the No
Fatigue condition (Experiment 1 and Experiment 2), (2) this destabilizing
effect was more accentuated in the Head tilted backward posture than Neutral
head posture (Experiment 1) and (3) this destabilizing effect was less
accentuated in the condition of Tactile stimulation than that of No tactile
stimulation of the neck (Experiment 2). In the context of the multisensory
control of balance, these results suggest an increased reliance on vestibular
and neck somatosensory information for controlling posture during quiet
standing in condition of altered ankle neuromuscular function
A theoretical model for the development of a diagnosis-based clinical decision rule for the management of patients with spinal pain
Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review
<p>Abstract</p> <p>Background</p> <p>Manual therapy is an intervention commonly advocated in the management of dizziness of a suspected cervical origin. Vestibular rehabilitation exercises have been shown to be effective in the treatment of unilateral peripheral vestibular disorders, and have also been suggested in the literature as an adjunct in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness.</p> <p>Methods</p> <p>A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria.</p> <p>Results</p> <p>A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity.</p> <p>Discussion</p> <p>Although it has been argued that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness, there are currently no observational and experimental studies demonstrating such effects. A rationale for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is presented.</p> <p>Conclusion</p> <p>There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is lacking. Further research to elucidate potential synergistic effects of manual therapy and vestibular rehabilitation is strongly recommended.</p