An interventional study of Sub Occipital Myofascial release and (SNAGS). and Sub Occipital Myofascial release. in Dizziness and Cervicogenic Headache, sponsored by Riphah International University. Not yet recruiting at 1 site in Pakistan. Open to participants aged 22 Years to 54 Years. Per ClinicalTrials.gov, last updated 2025-07-14.
Sponsored by Riphah International University · Not applicable, Interventional, and Treatment
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.
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.
226 studies on the registry are indexed under Dizziness; 56 are open to participants now.
This study's planned enrollment of 42 is close to the median of 43 across 170 interventional studies indexed under Dizziness.
Browse Dizziness studies →Riphah International University is the lead sponsor of 2,193 studies on the registry; 650 are open to participants now.
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Exclusion Criteria:
By neurologist .Vestibular disorders (e.g. Benign Paroxysmal Positional Vertigo, Meniere's disease, peripheral vestibulopathy)
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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. The patient will be free from the symptoms and will be instructed to discontinue movement when somewhat vertigo happened through the glide Implementation. In the beginning treatment period, that procedure will repeat six times. During the following therapy , Mulligan SNAGs will perform ten repetitions and mild excess compression will be used only if no vertigo will feel.
Other: Sub Occipital Myofascial release and (SNAGS).
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. This process will be performed three times a week on different days for two to three minutes, with five to seven times.
Other: Sub Occipital Myofascial release.
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.
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.
Visual Analogue Scale (VAS)
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.
Time frame: 4 weeks
Dizziness Handicap Inventory (DHI)
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
Time frame: 4 weeks
Numerical Pain Rating Scale (NPRS)
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)
Time frame: 4 weeks
Plan to share: No
Start is estimated for Jul 2025; primary completion for Sep 2025, 1 month later.
Of 82 non-industry interventional studies with no phase under Dizziness, half reached primary completion within 22 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 42. This study's planned 1 month is below that.
Counting every sponsor, half of 90 studies reached it within 20 months; a quarter within 8 and three quarters within 42.
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This study is not yet recruiting, as verified in Jul 2025. You cannot join it, but the record below documents what was studied.
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