Chuna Manual Therapy for Cervicogenic Dizziness

• Chuna Manual Therapy (Procedure): * Unique manual therapy in traditional Korean medicine * Mandatory techniques for neck part and selective techniques for other part (if necessary) * Selective techniques depends on a patient's condition (judged by traditional Korean medicine doctor)
• Usual care (Procedure): 1. Physical therapy based on traditional Korean medicine theory * Electrical stimulation: either Meridian muscle interferential current electricity or Meridian transcutaneous electricity * Heat stimulation: either Hot pack or Infrared lamp 2. Patient education * Physical and pathological explanation of cervicogenic dizziness * Cause and risk factors of cervicogenic dizziness * Functions of muscles related to cervicogenic dizziness * Home exercising to self-manage cervicogenic dizziness

Primary outcomes

• Change from baseline Dizziness Handicap Inventory (DHI) score at week 6 [Week 0, Week 6]

Secondary outcomes

• Change from baseline Dizziness Handicap Inventory (DHI) score at week 3 [Week 0, Week 3]
• Changes from baseline Mean Vertigo Score (MVS) at each measurement week [Week 0, Week 3, Week 6]
• Changes from baseline Visual Analogue Scale (VAS) score at each measurement week [Week 0, Week 3, Week 6]
• Changes from baseline Frequency of Dizziness score at each measurement week [Week 0, Week 3, Week 6]
• Changes from baseline Pain Intensity Numerical Rating Scale (PI-NRS) score at each measurement week [Week 0, Week 3, Week 6]
• Changes from baseline Neck Disability Index (NDI) score at each measurement week [Week 0, Week 3, Week 6]
• Changes from baseline Cervical Range of Motion (CROM) value at each measurement week [Week 0, Week 3, Week 6]
• Global Perceived Effect (GPE) score at each measurement week [Week 6]
• Changes from baseline Korean version of Perceived Stress Scale (K-PSS) score at each measurement week [Week 0, Week 3, Week 6]
• Changes from baseline EuroQoL Five Dimensions Questionnaire (EQ-5D) score at each measurement week [Week 0, Week 3, Week 6]

Other outcomes

• New Blinding Index (New BI) [Week 6]

Sex: All, ages: 20 Years to 70 Years

Inclusion Criteria:

* male or female aged between 20 and 70
* neck pain and/or stiffness with dizziness, which is related to movement or positioning of cervical spine
* recurring symptom of dizziness over 1 month or more
* Dizziness Handicap Inventory ≥ 16 at baseline
* Informed consent

Exclusion Criteria:

* dizziness induced by vestibular disorders (e.g., benign paroxysmal positional vertigo, peripheral vestibulopathy, Meniere disease, vestibular neuronitis)
* dizziness induced by central nervous system (CNS) disorders (e.g., cerebellar ataxia,cerebellum infarction/hemorrhage, demyelination, vertebrobasilar insufficiency, seizure, increased intracranial pressure, Parkinson's disease, migraines)
* dizziness induced by cardiovascular disorders (e.g., arrhythmia, heart valvular disease, anemia, orthostatic hypotension, coronary artery disease)
* dizziness induced by active or uncontrolled disease (e.g., uncontrolled diabetes mellitus, hypertension, respiratory or endocrinological disorders)
* dizziness induced by side effects of medications
* severe chronic or terminal diseases (malignant cancer, tuberculosis, etc.)
* chronic psychiatric diseases under treatment (epilepsy, depression, panic disorder, etc.)
* conditions where CMT are forbidden (spinal tumor, acute fracture, infectious spondylopathy, congenital malformations of spine, operation history of spine within 3 months, progressive neurological damage, severe neurological symptoms, spinal fixation devices, syringomyelia, hydrocephaly)
* Treatment history within 1 week for cervicogenic dizziness (NSAIDs, steroid, herbal drug, acupuncture, manual therapy)
* Women of (suspected) pregnancy or breast-feeding
* Suspicion of alcohol and/or drug abuse
* Participation in another clinical study within 1 month
* Difficulty in communicating with the investigators
* Other reasons for ineligibility of participation

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• Euiju Lee, Ph.D., Principal investigator, Kyunghee University