Prognostic indicators for decrease in tinnitus severity after cervical physical therapy in patients with cervicogenic somatic tinnitus.

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Prognostic indicators for decrease in tinnitus severity after cervical physical therapy in patients with cervicogenic somatic tinnitus.

Musculoskelet Sci Pract. 2017 Mar 06;29:33-37

Authors: Michiels S, Van de Heyning P, Truijen S, Hallemans A, De Hertogh W

Abstract
BACKGROUND: Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus(CST). Recently, a positive effect of multi-modal cervical physical therapy on tinnitus severity in patients with CST was demonstrated. To date however, the outcome of the intervention cannot be predicted.
OBJECTIVE: To identify prognostic indicators for decrease in tinnitus severity after cervical physical therapy in patients with CST.
PATIENTS: Patients with moderate to severe subjective tinnitus (Tinnitus Functional Index(TFI):25-90points) and neck complaints (Neck Bournemouth Questionnaire(NBQ) > 14points).
INTERVENTION: All patients received multimodal cervical physical therapy for 6 weeks (12 sessions). This physical therapy contained a combination of manual mobilizations and exercises of the cervical spine.
MEASUREMENTS: TFI and NBQ-scores were documented at baseline, after treatment and after a 6-weeks follow-up period. Impairments in cervical spine mobility and muscle function were identified at baseline and after 6-weeks follow-up.
RESULTS: Patients with co-varying (increasing or decreasing simultaneously) tinnitus and neck complaints had significantly lower TFI-scores after treatment (p = 0.001) and follow-up (p = 0.03). The presence of this co-variation and a combination of low pitched tinnitus and increasing tinnitus during inadequate cervical spine postures are prognostic indicators for a decrease in TFI-scores after cervical physical therapy (adjusted R(2) = 0.357).
CONCLUSION: Patients who experience a decrease in tinnitus annoyance from cervical physical therapy are those with co-varying tinnitus and neck complaints and those with a combination of low-pitched tinnitus and increasing tinnitus during inadequate cervical spine postures.

PMID: 28286241 [PubMed - as supplied by publisher]

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