Effectiveness of Vestibular Rehabilitation Therapy Combined With Cervical Mobilization in Patients With Cervicogenic Dizziness: A Randomized Controlled Trial

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Background: Cervicogenic dizziness (CGD) is a complex clinical syndrome characterized by dizziness, imbalance, and cervical musculoskeletal dysfunction, yet optimal treatment strategies remain insufficiently defined.Vestibular rehabilitation therapy (VRT) addresses sensory reweighting and gaze stabilization, while cervical mobilization (CM) targets upper cervical proprioceptive and musculoskeletal sources.Whether combining these modalities yields additive or synergistic benefits over VRT alone has not been rigorously evaluated in a randomized controlled trial.Objective: To evaluate the effectiveness of combined VRT and CM versus VRT alone on dizziness-related disability, cervical range of motion, postural stability, and quality of life in patients with cervicogenic dizziness over a 6-week intervention period.Methods: A prospective, parallel-group, single-blind randomized controlled trial was conducted at two tertiary physiotherapy centres in India.Seventy adults (18-65 years) with clinically confirmed CGD were randomly assigned (1:1) to Group A (VRT + CM, n=35) or Group B (VRT alone, n=35).Randomization used computer-generated block randomization with concealed allocation envelopes.Both groups received 18 supervised sessions over 6 weeks (3 sessions/week).Primary outcomes were the Dizziness Handicap Inventory (DHI) total score and Numeric Rating Scale (NRS) for dizziness intensity.Secondary outcomes included cervical range of motion (CROM goniometer), Timed Up and Go (TUG) test, modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Berg Balance Scale (BBS), Neck Disability Index (NDI), Visual Analogue Scale for neck pain (VAS), and Activities-specific Balance Confidence (ABC) Scale, all assessed at baseline and 6 weeks.Results: Both groups showed significant within-group improvements on all outcome measures (p<0.001).Group A demonstrated significantly greater reductions in DHI total score (Group A: 56.4→26.1,Group B: 55.8→38.7,between-group p<0.001,Cohen's d=1.24) and NRS dizziness (Group A: 6.8→2.4,Group B: 6.9→3.8,p<0.001).Group A also showed superior gains in cervical rotation (d=0.86),TUG test performance (d=0.75),mCTSIB Effectiveness of Vestibular Rehabilitation Therapy Combined with Cervical Mobilization in Patients with Cervicogenic Dizziness: A Randomized Controlled Trial IJDDT Volume 16 Issue 64s 2026 Page: 1590 composite (d=0.82),BBS (d=0.79),NDI (d=0.88),VAS neck pain (d=0.91), and ABC Scale (d=0.93).No serious adverse events occurred in either group. Conclusion:The combination of VRT with cervical mobilization produces clinically meaningful and statistically superior improvements over VRT alone in patients with cervicogenic dizziness.This multimodal approach should be considered as the preferred physiotherapy strategy for CGD management in clinical practice.