Tinnitus, Subjective
Conditions
Brief summary
Somatic tinnitus is an unpleasant perception of sound that occurs in the absence of any external acoustic stimulus. Despite the correct diagnosis of somatic tinnitus, there is currently no specific treatment. The hypothesis of this study is that the application of manual therapy to the cervical region will help to treat tinnitus in patients. This study aims to investigate the effectiveness of manual therapy in the treatment of somatic tinnitus of cervicogenic origin.
Detailed description
Somatic tinnitus is an unpleasant perception of sound that occurs in the absence of any external acoustic stimulus. It results from complex interactions between the somatosensory and auditory systems, which involve the musculoskeletal system rather than the ear. The temporomandibular joint, craniocervical junction, cervical vertebrae and neck and shoulder muscles, in particular the sternocleidomastoid (SCM) muscle, upper trapezius and levator scapula, are anatomical regions that can cause somatic tinnitus. Despite the correct diagnosis of somatic tinnitus, there is currently no specific treatment. The hypothesis of this study is that the application of manual therapy to the cervical region will help to treat tinnitus in patients. This study aims to investigate the effectiveness of manual therapy in the treatment of somatic tinnitus of cervicogenic origin.
Interventions
OTHERManual Therapy
Manual Therapy
OTHERExercise
Isometric and strengthening exercises for the cervical region, which are provided to patients with cervical pain and limitation
Sponsors
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Patients aged ≥ 18 and ≤ 65 years Patients fulfilling the clinical criteria4 defined for sevichogenic somatic tinnitus 1. Neck pain 2. Cervical joint range of motion limitation (especially rotation) 3. Modulation of tinnitus in relation to head and neck movements and posture 4. Tenderness in the cervico-occipital muscles Patients reporting cervical pain between \>2 and \<7 on a visual analogue scale (VAS) on most days of the last month Patients with stable medical and psychological status Patients willing to participate in the study
Exclusion criteria
Objective tinnitus Subjective tinnitus with hearing loss Meniere's disease History of vertigo Middle ear pathologies History of intracranial pathology History of whiplash injury History of cervical spinal surgery History of active infection, malignancy, inflammatory rheumatic disease or fibromyalgia Pregnancy Patients who have undergone any exercise or physiotherapy programme for the cervical region in the last 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale for Tinnitus (VAS-tinnitus) | baseline- week 3 - week 6 | The severity of tinnitus will be graded using a 10 cm visual analogue scale (VAS, 0-10 cm; 0 means no tinnitus, 10 means extremely severe tinnitus). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale for cervical pain (VAS-Cervical) | baseline- week 3 - week 6 | Pain intensity will be assessed with the visual analogue scale (0-10mm), which has proven validity and reliability for measuring musculoskeletal pain. |
| Tinnitus Handicap Index (THI) | baseline- week 3 - week 6 | The THI contains a total of 25 items with functional (11 items), emotional (9 items) and catastrophic (5 items) subscales. Each item is rated 0 (not affected), 2 (sometimes affected) or 4 (always affected). The total score ranges from 0 to 100, with higher scores indicating higher levels of disability of perceived tinnitus. |
| Neck disability index (NDI) | baseline- week 3 - week 6 | The NDI is designed to assess self-reported neck functional status. The questionnaire consists of 10 items related to pain, activities of daily living, weight lifting, reading, headache, concentration, working status, driving, sleep and recreation and is rated on a 6-point Likert scale ranging from 0 (no disability) to 50 (major disability). Higher scores represent greater disability. The NDI has been found to be reliable and valid for cervical disorders. |
| Cervical range of motion (ROM) | baseline -week 3- week 6 | Cervical range of motion (ROM) |
| Manual muscle testing (MMT) | baseline - week 3 -week 6 | MMT for assessing strength of cervical flexors, extensors, lateral flexors, and rotators |
| Myofascial trigger point of the SCM, upper trapezius, levator scapulae, splenius capitis | baseline- week 3- week 6 | Myofascial trigger point of the SCM, upper trapezius, levator scapulae, splenius capitis |
| Tinnitus provocation with ROM | Baseline- week 3- week 6 | Tinnitus provocation with ROM |
| Tinnitus provocation with MMT | Baseline- week 3- week 6 | Tinnitus provocation with MMT |
| Tinnitus provocation with myofascial trigger point palpation | Baseline- week 3- week 6 | Tinnitus provocation with myofascial trigger point palpation |
| SF-36 quality of life scores | Baseline- week 3- week 6 | SF-36 is a widely validated and reliable generic measure of health-related quality of life, covering eight domains: physical functioning, role limitations due to physical and emotional problems, pain, general health, vitality, social functioning, and mental health. Each subscale score ranges from 0 (worst) to 100 (best) |
Countries
Turkey (Türkiye)
Outcome results
None listed