Article ID Journal Published Year Pages File Type
2625144 Manual Therapy 2016 8 Pages PDF
Abstract

•Evaluation of somatosensory tinnitus should be a regular feature in tinnitus patients.•Manual therapists have a role in the management of patients with somatosensory tinnitus.•Additional evidence is needed to verify the effectiveness of manual therapy.•Verification of manual therapy with tinnitus education is needed.

ObjectivesThe aim of this study was to evaluate the efficacy of Manual Therapy Utrecht (MTU) plus education in patients with cervicogenic somatosensory tinnitus (CeT).Study designPretest–posttest design.MethodFive hundred and six patients were referred or referred themselves. A subgroup of patients was identified with CeT, and within this a subgroup with tinnitus sensitization (TS). Two CeT groups were created based on the presence or absence of TS. Both groups underwent manual therapy combined with tinnitus education. Tinnitus intensity (VAS-tin 0–100 mm) was the primary outcome measure. Number of treatments and adverse effects were the secondary outcome measures.ResultsA total of 122 patients with CeT (24.1%) were included (average age 53.3 years [±9.8], female 38.5% and duration of tinnitus 7.3 years [±8.9]). Patients were divided into two groups: 55 patients (45.1%) with TS (CeT + TS group) and 67 patients (54.9%) without TS (CeT − TS group). Pretest to posttest differences on the VAS-tin were statistically significant within both groups (CeT − TS group: difference VAS-tin 5.9 [p = 0.01]; CeT + TS group: difference VAS-tin 18.2 [p = 0.00]), and between the groups in favor of the CeT + TS group (difference VAS-tin 12.3 [p = 0.01]). Pretest to posttest differences were clinically significant for the CeT + TS group (difference VAS-tin 18.2 [MCIC = ≥10 mm VAS-tin]) and between the groups (difference VAS-tin 12.3 in favor of the CeT + TS group). The average number of treatment sessions was 9.6 (±2.6) for the CeT − TS group and 10.3 (±2.5) for the CeT + TS group, a non-significant difference. There were no adverse effects in either group.ConclusionsDespite its limitations, this study provides valuable information on both the characteristics of patients with CeT and TS in a Dutch primary care manual therapy practice and on the potential effectiveness of MTU combined with tinnitus education for the subgroup of CeT + TS patients.

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