Improvement In Neck Curve and Posture Using the Denneroll Improves Long Standing Dizziness, Neck Pain, and Disability in Cervico-Genic Dizziness Sufferers.
Cervicogenic dizziness is a frequent disorder that is strongly associated with delayed recovery, persistent disability, psychologic distress and increased health care utilization and costs.1, 2 Despite the relatively high prevalence of this condition, its management has long been a challenge for both clinicians and patients.3-5 In general there is mild-moderate (30-50% improvement in the condition) short term treatment outcomes immediately after intervention and 3- month follow up, however, there is no strong evidence for the effectiveness of most treatments at long-term management follow-ups of 1 year or longer.
Causes of Cervico-Genic Dizziness
There is evidence that cervicogenic dizziness is a result of perturbation in the information from sensory afferents in the cervical spine.6 Abnormal alignment of the cervical lordotic curve from the side view (straightening and kyphosis) has been found to result in degenerative changes in the muscles, ligaments, intervertebral discs and bony structures of the cervical spine.7,8 This altered alignment and degenerative cascade could potentially lead to mechanoreceptive dysafferentation (abnormal and altered barrage of afferent neurological input). A correction of altered cervical spine alignment therefore, might be required to achieve optimal information from sensory afferents in the cervical spine, where the signs and symptoms of patients with cervicogenic dizziness can be decreased. The development of effective intervention strategies and trials testing this concept in Dizziness patients is thus sorely needed.
Figure 1. Cervical Denneroll Device. Image ©Copyright CBP Seminars and Deed Harrison, LLC. Reprinted with Permission. All rights reserved.
New Breakthrough Randomized Trial9
Recently a breakthrough randomized trial was conducted at Cairo University in Egypt and co-authored by CBP NonProfit President Dr. Deed Harrison, DC. The Cairo University team was led by Professor Ibrahim Moustafa, PT, PhD and included collaborating author Professor Aliaa Diab PT, PhD.9
Clinical features: The study investigated 72 patients (47 males) aged 40-55 years with chronic pain and disability with a primary complaint and diagnosis of cervico-genic dizziness. The short (10-weeks) and long term (1-year) outcomes of neck pain, dizziness severity and frequency, and cervical positioning sense were assessed in the project.
Interventions: The investigation used a standard intervention frequency and duration of 3x per week for 10 weeks or 30 total treatment sessions. Patient participants were assigned equally to one of two groups: Denneroll group and Non-Denneroll Group. Of interest both groups received a standardized multiple treatment procedure protocol including:
- Cervical Spinal joint mobilization therapy for the cervical spine,
- Myofascial stretching and release techniques to the sub-occipital spine,
- Tens and hot packs to the cervical region,
- Functional and strengthening exercise protocol designed to improve strength, flexibility, posture, and reduce pain,
- A series of home care instructions.
Only the Denneroll group received the cervical denneroll in addition to the standardized multiple treatment techniques. Figure 1. shows the Cervical Denneroll device.
All treatments were applied 3x per week for 10 weeks. At the end of the 30 treatments, following a minimum of 1-day with no treatment, all subjects were re-evaluated. Lastly, treatment was then stopped and all subjects were followed for an additional 1-year to see if the 10-week outcomes were maintained at this long term follow up.
Important Findings and Conclusion: The addition of the cervical denneroll orthotic device to a multi-modal physical therapy intervention program was found to improve the cervical lordotic curvature by an average of 14° and improve anterior head translation by 2.4cm. This improvement in cervical curvature and posture in the Denneroll group was found to be associated with improvement in dizziness disability and severity and frequency, chronic neck pain, and head repositioning accuracy. In the group receiving the denneroll and consequent curve correction, their results were maintained at 1-year follow up whereas the control subjects regressed back to baseline values for all clinically relevant measures.16
Figure 2. Depicts an example of a patient’s lateral cervical spine x-ray with a cervical kyphosis and then the 10-week and the long term follow up x-rays indicating correction.
Figure 2. Example Before, After 10 weeks of treatment, and 1 year follow up x-rays of a patient with a cervical kyphosis whose curve has been corrected towards a cervical lordosis with the Cervical Denneroll and other interventions. Image ©Copyright CBP Seminars and Deed Harrison, LLC. Reprinted with Permission. All rights reserved.
How Can You Get Help for Your Dizziness and Altered Posture and Other Health Disorders?
Chiropractic BioPhysics® (CBP®) and Denneroll trained corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their cervical spines back to health, and eliminate a potential source of Dizziness, chronic neck pain, chronic headaches and migraines, general pain syndromes, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See www.CBPpatient.com for providers in your area.
- Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA. Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. Br Med J 1996;313:788–93.
- Yardley L, Owen N, Nazareth I, Luxon L. Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract 1998;48(429): 1131-5.
- Yardley L, Todd AM, Lacoudraye-Harter MM, Ingham R. Psychosocial consequences of recurrent vertigo. Psychol Health 1992;6:85–96.
- Reid SA, Rivett DA. Manual therapy treatment of cervicogenic dizziness: a systematic review. Man Ther 2005;10(1):4-13.
- Karlberg M, Magnusson M, Malmstrom EM, Melander A, Moritz U. Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin. Arch Phys Med Rehabil 1996;77(9):874-82.
- Brandt T, Bronstein AM. Cervical vertigo. J Neurol Neurosurg Psychiatry 2001;71(1):8–12.
- Harrison DE, Harrison DD, Janik TJ. Comparison of axial and flexural stresses in lordosis and three buckled configurations of the cervical spine. Clin Biomech 2001; 16(4):276-84
- Harrison DE, Cailliet R, Harrison DD, Troyanovich SJ, Harrison SO. A Review of Biomechanics of the Central Nervous System. PART II: Strains in the Spinal Cord from Postural Loads. J Manipulative Physiol Ther 1999; 22(5):322-332.
- Moustafa IM, Diab AA, Harrison DE. The effect of normalizing the sagittal cervical configuration on dizziness, neck pain, and cervicocephalic kinesthetic sensibility: A 1-year randomized controlled study. European Journal of Physical and Rehabilitation Medicine 2016; In Press. Online Pre-Press accepted version at: http://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y9999N00A16083002