Universitat Internacional de Catalunya

Manual Therapy for the Pelvis, Spine and Orofacial Region

Manual Therapy for the Pelvis, Spine and Orofacial Region
9
13884
1
Second semester
OB
Main language of instruction: Spanish

Other languages of instruction: Catalan, English

Teaching staff

Introduction

This subject includes practical and theoretical content related to the development and application of manual therapy techniques for the pelvis, spine and TMJ regions. The student will learn and improve abilities and skills to evaluate and treat joint, neural and muscular dysfunctions located in the pelvis, spine and TMJ regions. The course includes both manual and instrumental assessment and treatment methodologies.

Pre-course requirements

No prerequisites are specified.

Objectives

  1. To demonstrate palpatory skills in the identification of the different structures of the pelvis, spine and TMJ regions.
  2. To carry out an inspection of pelvis, spine and TMJ regions under load, both statically and dynamically, and interpret the findings.
  3. To perform and interpret the clinical tests necessary to assess the specific function of the physiological and anatomical joints of the pelvis, spine and TMJ regions {active and passive rotatory movements, translational movements of joint play, resisted movements, passive soft tissue movements [physiological and accessory movement, muscle and compartmental play)].
  4. To execute treatment techniques according to the therapeutic objective of pain modulation or function improvement.
  5. To know the clinical presentation of the most typical syndromes and clinical categories of the pelvis, spine and TMJ regions.

Competences/Learning outcomes of the degree programme

General and basic competencies:

  • CB7: To develop the skills to apply the knowledge acquired and their ability to solve problems in new or little-known environments within broader (or multidisciplinary) contexts related to their area of study.
  • CB8: To have the skills to integrate knowledge and face the complexity of formulating judgments based on information that, being incomplete or limited, includes reflections on the social and ethical responsibilities linked to the application of their knowledge and judgments.
  • CB9: To have the skills to communicate their conclusions as well as the knowledge and ultimate reasons that support them, aimed at specialized and non-specialized audiences in a clear and unambiguous way.
  • CB10: To have the ability to develop learning skills that allow them to continue studying in a way that will be largely self-directed or autonomous.
  • CG2: To know how to effectively manage professional and clinical situations that require the integration of knowledge of biomedical, clinical and behavioral sciences in the area of specialization of Manual Orthopedic Physiotherapy.
  • CG3: Knowing how to carry out specific evaluation and treatment procedures for arthro-neuro-muscular dysfunctions, establishing a diagnosis of Orthopedic Manual Physiotherapy based on the findings.

Transversal competencies:

  • CT1: Being able to communicate effectively and to carry out an anamnesis, an evaluation and treatment of arthro-neuro-muscular dysfunctions, in interpersonal relationships so that they lead to enhancing the health status of the patient/user and the collaboration of the multidisciplinary team.
 Specific competencies:
  • CE1: To determine and apply the most appropriate treatment, taking into account the indications, contraindications, precautions and effects of Manual Orthopedic Physiotherapy in the framework of the management of pain mechanisms and dysfunctions of the arthro-neuro-muscular system.  
  • CE4: To have the ability to specifically execute the principles of mobilization, manipulation, motor learning, exercise physiology, ergonomic strategies, among other therapeutic modalities, for the treatment of pain and function of the arthro-neuromuscular system specifically, such as multimodal elements of the therapeutic approach of Orthopedic Manual Physiotherapy.

 

Learning outcomes of the subject

Students will:

  • Demonstrates extensive knowledge of the types of pain and neurophysiological mechanisms involved in nociception as well as peripheral and central sensitivity processes.

  • To give due importance to the mechanosensitivity of the patient's dysfunction.

  • Demonstrate advanced and specialized knowledge of the specific anatomy, physiology, and biomechanics of the musculoskeletal, neurological, vascular, and lymphatic systems of the pelvis, spine and TMJ regions.

  • Demonstrate palpatory skills in identifying the different structures of the pelvis, spine and TMJ regions.

  • Perform an inspection of the pelvis, spine and TMJ regions under load, both statically and dynamically, and interpret the findings.

  • Demonstrates abilities and skills in performing and interpreting safety tests of the cervical region.

  • Demonstrate advanced knowledge and abilities and skills in performing and interpreting the clinical tests necessary to assess the specific function of the physiological and anatomical joints of the pelvis, spine and TMJ regions {active and passive rotatory movements, translatory movements of joint play, resisted movements, passive movements of soft tissue [physiological and accessory movement (muscular play and compartmental play)].

  • Demonstrate advanced knowledge and abilities and skills in the execution of treatment techniques according to the therapeutic objective of pain modulation or function improvement.

  • Demonstrate critical awareness of the need and importance of specificity in the execution of the evaluation and treatment of osteo-arthro-neuro-myofascial dysfunctions of the pelvis, spine and TMJ regions.

  • Demonstrate advanced knowledge of the clinical presentation of the most typical syndromes and clinical categories of the pelvis, spine and TMJ regions, as well as specific abilities and skills in their evaluation and treatment.

Syllabus

  1. Neurophysiology of pain: 
    1. Mechanisms of nociception
    2. Types of pain 
    3. Peripheral, central sensitization and chronic pain 
  2. Functional and biomechanical anatomy of the sacroiliac, lumbar, thoracic, cervical and temporomandibular regions.
  3. Structural and functional palpation of the sacroiliac, lumbar, thoracic, cervical and temporomandibular regions.
  4. Static and dynamic inspection of the spine.
  5. Cervical region safety test. 6. Functional evaluation of the spine.
  6. Treatment techniques for spinal column according to therapeutic objective: 
    1. Symptom relief: pain modulation techniques, clinical neurodynamics, functional taping. 
    2. Increased joint mobility: slow joint mobilization of traction and sliding and joint manipulation. 
    3. Increased muscle mobility: dry needling, diacutaneous fibrolysis, functional massage and muscle stretching.
    4. Mobility limitation: passive stabilization and mobilization of adjacent regions.
  7. Evaluation and treatment of the most frequent clinical presentations (clinical subgroups) of the spine: 
  8. Sacroiliac region: 
    1. Positional faults (nutation and counternutation) 
    2. Sacroiliac instability 
  9. Lumbar region: 
    1. Lumbar radiculopathy 
    2. Clinical lumbar instability 
    3. Lumbar facet syndrome 
    4. Lumbar stenosis 
    5. Chronic pain 
  10. Thoracic region 
    1. Thoracic hypomobility 
    2. Rib dysfunctions 
    3. T4 syndrome 
    4. Autonomic nervous system dysfunctions 
  11. Cervical and temporomandibular region:
    1. Cervicogenic headache 
    2. Cervicogenic dizziness 
    3. Cervical radiculopathy 
    4. Clinical cervical instability 
    5. Vestibular dysfunctions 
    6. Cervical facet syndrome 
    7. Orofacial and TMJ dysfunctions 
  12. Chronic pain

Teaching and learning activities

In person



  • TC (Theoretical classes): The teacher is the one who exposes in a systematic and orderly manner the information corresponding to the different subjects and the student has a role mainly as a receiver. The scenario in which the teacher transmits knowledge is the classroom and he does it to the entire group of students. The theoretical class format allows the introduction of group activities in the classroom and the development of strategies that encourage the active participation of students.
  • PC (Practical classes):  It includes any type of classroom and/or laboratory practice (practices among students, case studies, problems, activities in the computer room, search for information,...)
  • SLA (Self-learning activities: These activities are designed so that the student solves problems on their own with the help of the material provided and the information from the face-to-face activities and/or available in the virtual environment in which the online subjects are developed.
  • SIS (Student independent study): It is a process aimed at the formation of an autonomous student capable of learning to learn; It consists of developing study skills, establishing educational goals and objectives based on the recognition of the weaknesses and strengths of the individual, which will respond to the needs and expectations of each one. It implies the possibility that each student makes their own decisions in relation to the organization of their time and their learning pace, which is why it requires a high degree of responsibility to make the most of resources.Includes study of contents related to "theoretical classes" and "practices" (studying exams, carrying out individual and group theoretical work, library work, complementary reading, etc.).
  • MC (Master Class): Transmission of knowledge and activation of cognitive processes in the student.
  • CL (Cooperative learning): Development of active and significant learning cooperatively.
  • FL (Flipped learning): Systems based on new technologies as basic knowledge tools outside the classroom, so that when students arrive to class they put their ideas and impressions together, giving teachers the opportunity to personalize their instruction according to the needs of each one.
  • PBL (Problem based learning): Development of active learning through problem solving.
  • RP (Role playing): Transfer to the classroom of situations typical of reality that will serve the student to apply them in their future life.

Evaluation systems and criteria

In person



  • Theoretical evaluation: 10%
  • Practical evaluation: 25%
  • Oral evaluation: 5%
  • Narrative report: 20%
  • Self-assessment: 20%
  • Co-assessment: 20%

The grading system will be used in accordance with current legislation.

Actually, according to RD 1.125/2003 del 5 de septiembre.

  • 0-4,9 Fail.
  • 5,0-6,9 Pass.
  • 7,0-8,9 Notable.
  • 9,0-10 Outstanding.

The Honor Roll mention may be awarded to students who have obtained a grade equal to or greater than 9.0. Their number may not exceed 5% of the students enrolled in a subject in the corresponding academic year, unless the number of students enrolled is less than 20, in which case a single Honors may be awarded.

Bibliography and resources

  • Manual Mobilization of the Joints, Volume III: Traction-Manipulation of the Extremities and Spine: Amazon.es: Kaltenborn, Freddie.
  • Manual Mobilization of the Joints. Volume II : joint examination and basic treatment : Spine
  • Anatomy | THIEME Atlas of Anatomy, Three Volume Set, Third Edition. Third Edition. https://www.thieme.com/books-main/anatomy/product/5701-thieme-atlas-of-anatomy-three-volume-set-third-edition. Published December 2020. Accessed July 4, 2021.
  • Shacklock MO, Neurodynamic Solutions. Biomechanics of the nervous system : Breig revisited. 2007;218.
  • Hing W, Hall T, Rivett D, Vicenzino B, Mulligan B. The Mulligan Concept of Manual Therapy: Textbook of Techniques, 1e : Hing PhD MSc(Hons) ADP(OMT) DipMT Dip Phys FNZCP, Wayne, Hall PT PHD MSc FACP, Toby, Mulligan FNZSP (Hon.) Dip MT, Brian.
  • Maitland GD (Geoffrey D, Hengeveld E, Banks K, Newton M. Maitland manipulación vertebral : tratamiento de los trastornos neuromusculoesqueléticos. 2015
  • Netter. Exploración clínica en ortopedia: Un enfoque basado en la evidencia eBook: Cleland, Joshua, Koppenhaver, Shane, Cleland, Joshua, Koppenhaver, Shane, Su, Jonathan, DRK EDICION, SL.Simons DG, Travell JG, Simons LS. Dolor y disfuncion miofascial V.1: El manual de los puntos gatillo, mitad ... - David G. Simons, Janet G. Travell.
  • Travell JG, Simons DG. Dolor y disfunción miofascial. El manual de los puntos gatillo. Volumen 2: extremidades inferiores. Medica Panam. 2004;752. 
  • Lima POP, Melo WPX, Bezerra MA, Almeida GPL, Nunes ACL, Oliveira RR. Intraexaminer and Interexaminer Reproducibility of the Downing Test for Sacroiliac Joint Evaluation of Symptomatic and Asymptomatic Individuals. J Chiropr Med. 2019 Sep 1;18(3):163–70. 
  • Arab AM, Abdollahi I, Joghataei MT, Golafshani Z, Kazemnejad A. Inter- and intra-examiner reliability of single and composites of selected motion palpation and pain provocation tests for sacroiliac joint. Man Ther. 2009 Apr;14(2):213–21. 
  • Nejati P, Sartaj E, Imani F, Moeineddin R, Nejati L, Safavi M. Accuracy of the Diagnostic Tests of Sacroiliac Joint Dysfunction. J Chiropr Med. 2020 Mar 1;19(1):28–37. 
  • Shimpi A, Hatekar R, Shyam A, Sancheti P. Reliability and validity of a new clinical test for assessment of the sacroiliac joint dysfunction. Hong Kong Physiother J. 2018 Jun 1;38(1):13–22. 
  • Himstead AS, Brown NJ, Shahrestani S, Tran K, Davies JL, Oh M. Trends in Diagnosis and Treatment of Sacroiliac Joint Pathology Over the Past 10 Years: Review of Scientific Evidence for New Devices for Sacroiliac Joint Fusion. Cureus. 2021 Jun 3; 
  • Cibulka MT, Morr B, Wedel J, Bohr Z, Jones G, Herman C, et al. Changes in pelvic tilt during three different reciprocal stance positions in patients with sacroiliac joint regional pain. Int J Sports Phys Ther [Internet]. 2019 Dec [cited 2021 Jul 19];14(6):967–77. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31803529
  • Telli H, Telli S, Topal M. The validity and reliability of provocation tests in the diagnosis of sacroiliac joint dysfunction. Pain Physician. 2018 Jul 1;21(4):E367–76. 
  • Laslett M, Aprill CN, McDonald B. Provocation Sacroiliac Joint Tests Have Validity in the Diagnosis of Sacroiliac Joint Pain. Arch Phys Med Rehabil. 2006 Jun;87(6):874. 
  • Reeves N, Cholewicki J, Van-Dieën J, Kawchuk G, Hodges P. Are Stability and Instability Relevant Concepts for Back Pain? J Orthop Sports Phys Ther [Internet]. 2019 Jun 1;49(6):415–24. Available from: https://pubmed.ncbi.nlm.nih.gov/31021689/
  • Macedo L, Hodges P, Bostick G, Hancock M, Laberge M, Hanna S, et al. Which Exercise for Low Back Pain? (WELBack) trial predicting response to exercise treatments for patients with low back pain: a validation randomised controlled trial protocol. BMJ Open [Internet]. 2021 Jan 20;11(1). Available from: https://pubmed.ncbi.nlm.nih.gov/33472786/
  • Ranger T, Cicuttini F, Jensen T, Peiris W, Hussain S, Fairley J, et al. Are the size and composition of the paraspinal muscles associated with low back pain? A systematic review. Spine J [Internet]. 2017 Nov 1;17(11):1729–48. Available from: https://pubmed.ncbi.nlm.nih.gov/28756299/
  • Tong M, Mousavi S, Kiers H, Ferreira P, Refshauge K, Van-Dieën J. Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis. Arch Phys Med Rehabil [Internet]. 2017 Jan 1;98(1):120-136.e2. Available from: https://pubmed.ncbi.nlm.nih.gov/27317866/
  • Ferrari S, Manni T, Bonetti F, Villafañe J, Vanti C. A literature review of clinical tests for lumbar instability in low back pain: validity and applicability in clinical practice. Chiropr Man Therap [Internet]. 2015 Apr 8;23(1). Available from: https://pubmed.ncbi.nlm.nih.gov/25866618/
  • Denteneer L, Stassijns G, De Hertogh W, Truijen S, Van Daele U. Inter- and Intrarater Reliability of Clinical Tests Associated With Functional Lumbar Segmental Instability and Motor Control Impairment in Patients With Low Back Pain: A Systematic Review. Arch Phys Med Rehabil. 2017 Jan 1;98(1):151-164.e6. 
  • Navarro-Brazález, Prieto-Gómez, Prieto-Merino, Sánchez-Sánchez, McLean, Torres-Lacomba. Effectiveness of Hypopressive Exercises in Women with Pelvic Floor Dysfunction: A Randomised Controlled Trial. J Clin Med [Internet]. 2020 Apr 17;9(4):1149. Available from: https://pubmed.ncbi.nlm.nih.gov/32316686/
  • Berry J, Elia C, Saini H, Miulli D. A Review of Lumbar Radiculopathy, Diagnosis, and Treatment. Cureus [Internet]. 2019 Oct 17;11(10). Available from: https://pubmed.ncbi.nlm.nih.gov/31788391/
  • Kuligowski T, Skrzek A, Cieślik B. Manual therapy in cervical and lumbar radiculopathy: A systematic review of the literature. Int J Environ Res Public Health. 2021 Jun 1;18(11). 
  • Vanti C, Turone L, Panizzolo A, Guccione AA, Bertozzi L, Pillastrini P. Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother. 2021 Dec;11(1). 
  • Li, Liu, Zheng, Miao, Chen, Quan, et al. Diagnosis of Compressed Nerve Root in Lumbar Disc Herniation Patients by Surface Electromyography. Orthop Surg [Internet]. 2018 Feb 1;10(1):47–55. Available from: https://pubmed.ncbi.nlm.nih.gov/29424098/
  • Tawa N, Rhoda A, Diener I. Accuracy of magnetic resonance imaging in detecting lumbo-sacral nerve root compromise: A systematic literature review. BMC Musculoskelet Disord. 2016 Sep 6;17(1). 
  • Heneghan N, Pup C, Koulidis K, Rushton A. Thoracic adverse events following spinal manipulative therapy: a systematic review and narrative synthesis. J Man Manip Ther [Internet]. 2020;28(5):275–86. Available from: https://pubmed.ncbi.nlm.nih.gov/32148185/
  • Strunce J, Walker M, Boyles R, Young B. The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain. J Man Manip Ther [Internet]. 2009;17(4):230–6. Available from: https://pubmed.ncbi.nlm.nih.gov/20140154/
  • Dunning J, Mourad F, Giovannico G, Maselli F, Perreault T, Fernández-De-Las-Peñas C. Changes in Shoulder Pain and Disability after Thrust Manipulation in Subjects Presenting with Second and Third Rib Syndrome. J Manipulative Physiol Ther. 2015 Jul 1;38(6):382–94. 
  • McDevitt A, Young J, Mintken P, Cleland J. Regional interdependence and manual therapy directed at the thoracic spine. J Man Manip Ther. 2015 Jul 1;23(3):139–46. 
  • Engel R, Grace S, Broadbent S. The effect of manual therapy and exercise on age-related lung function: study protocol for a randomised controlled trial. Trials [Internet]. 2019 Mar 13;20(1). Available from: https://pubmed.ncbi.nlm.nih.gov/30867017/
  • Van Kleef M, Stolker RJ, Lataster A, Geurts J, Benzon HT, Mekhail N. 10. Thoracic pain. Pain Pract. 2010;10(4):327–38. 
  • Nomden, Slagers, Bergman, Winters, Kropmans, Dijkstra. Interobserver reliability of physical examination of shoulder girdle. Man Ther [Internet]. 2009 Apr;14(2):152–9. Available from: https://pubmed.ncbi.nlm.nih.gov/18329943/
  • Foley C, Sugimoto D, Mooney D, Meehan W, Stracciolini A. Diagnosis and Treatment of Slipping Rib Syndrome. Clin J Sport Med [Internet]. 2019 Jan 1;29(1):18–23. Available from: https://pubmed.ncbi.nlm.nih.gov/29023277/
  • Van Tassel D, McMahon LE, Riemann M, Wong K, Barnes CE. Dynamic ultrasound in the evaluation of patients with suspected slipping rib syndrome. Skeletal Radiol. 2019 May 1;48(5):741–51. 
  • McMahon LE. Slipping Rib Syndrome: A review of evaluation, diagnosis and treatment. Semin Pediatr Surg. 2018 Jun 1;27(3):183–8. 
  • Fares MY, Dimassi Z, Baydoun H, Musharrafieh U. Slipping Rib Syndrome: Solving the Mystery of the Shooting Pain. Am J Med Sci. 2019 Feb 1;357(2):168–73. 
  • Funakoshi, Furushima, Kusano, Itoh, Miyamoto, Horiuchi, et al. First-Rib Stress Fracture in Overhead Throwing Athletes. J Bone Joint Surg Am [Internet]. 2019 May 15 [cited 2021 Jul 19];101(10):896–903. Available from: https://pubmed.ncbi.nlm.nih.gov/31094981/
  • Kawashima K, Terabayashi N, Asano H, Akiyama H. Classification of stress fractures of the first rib in adolescent athletes. J Pediatr Orthop B [Internet]. 2020 Jul 1;29(4):409–11. Available from: https://pubmed.ncbi.nlm.nih.gov/32044858/
  • Piech J, Pihut M, Kulesa-Mrowiecka M. Physiotherapy in hypomobility of temporomandibular joints. Folia Med Cracov. 2020;LX:123–34. 
  • Asquini G, Bianchi AE, Heneghan NR, Rushton AB, Borromeo G, Locatelli M, et al. Predictors of pain reduction following manual therapy in patients with temporomandibular disorders: a protocol for a prospective observational study. BMJ Open [Internet]. 2019 Nov 1 [cited 2021 Jul 27];9(11):e032113. Available from: https://bmjopen.bmj.com/content/9/11/e032113
  • Botticchio A, Mourad F, Fernández-Carnero S, Arias-Buría JL, Bueno AS, Jiménez JM, et al. Short-Term Morphological Changes in Asymptomatic Perimandibular Muscles after Dry Needling Assessed with Rehabilitative Ultrasound Imaging: A Proof-of-Concept Study. J Clin Med [Internet]. 2021 Jan 8 [cited 2021 Jul 27];10(2):209. Available from: https://www.mdpi.com/2077-0383/10/2/209/htm
  • Zhang C, Wu J, Deng D, BY H, Tao Y, Niu Y, et al. Efficacy of splint therapy for the management of temporomandibular disorders: a meta-analysis. Oncotarget [Internet]. 2016 [cited 2021 Jul 27];7(51):84043–53. Available from: https://pubmed.ncbi.nlm.nih.gov/27823980/
  • Nokar S, Sadighpour L, Shirzad H, Shahrokhi Rad A, Keshvad A. Evaluation of signs, symptoms, and occlusal factors among patients with temporomandibular disorders according to Helkimo index. Cranio [Internet]. 2019 Nov 2 [cited 2021 Jul 27];37(6):383–8. Available from: https://pubmed.ncbi.nlm.nih.gov/29602287/
  • Neblett R, Cohen H, Choi Y, Hartzell MM, Williams M, Mayer T, et al. The Central Sensitization Inventory (CSI): establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J pain [Internet]. 2013 May [cited 2021 Jul 27];14(5):438–45. Available from: https://pubmed.ncbi.nlm.nih.gov/23490634/
  • Neblett R, Hartzell MM, Mayer TG, Cohen H, Gatchel RJ. Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory. Pain Pract. 2017 Feb 1;17(2):166–75. 
  • Bas B, Yılmaz N, Gökce E, Akan H. Diagnostic value of ultrasonography in temporomandibular disorders. J Oral Maxillofac Surg [Internet]. 2011 May [cited 2021 Jul 27];69(5):1304–10. Available from: https://pubmed.ncbi.nlm.nih.gov/21256654/
  • Al-Saleh M, Alsufyani N, Saltaji H, Jaremko J, Major P. MRI and CBCT image registration of temporomandibular joint: a systematic review. J Otolaryngol Head Neck Surg [Internet]. 2016 [cited 2021 Jul 27];45(1). Available from: https://pubmed.ncbi.nlm.nih.gov/27164975/
  • Ferreira LA, Francischetti FL, Júnior AML de F, Paula MVQ de, Januzzi E, Carvalho ACP. Indication Criteria of Imaging Exams for Diagnosing of Temporomandibular Joint Disorders. J Clin Exp Pathol [Internet]. 2014 Sep 12 [cited 2021 Jul 27];4(5):1–6. Available from: https://www.omicsonline.org/open-access/indication-criteria-of-imaging-exams-for-diagnosing-of-temporomandibular-joint-disorders-2161-0681.1000190.php
  • Joury E, Bernabe E, Gallagher JE, Marcenes W. Burden of orofacial pain in a socially deprived and culturally diverse area of the United Kingdom. Pain [Internet]. 2018 Jul 1 [cited 2021 Jul 27];159(7):1235–43. Available from: https://journals.lww.com/pain/Fulltext/2018/07000/Burden_of_orofacial_pain_in_a_socially_deprived.7.aspx
  • Fiorillo L, Musumeci G. TMJ Dysfunction and Systemic Correlation. J Funct Morphol Kinesiol [Internet]. 2020 [cited 2021 Jul 27];5(1). Available from: /pmc/articles/PMC7739301/
  • White J, Savvides P, Cherian N, Oas J. Canalith repositioning for benign paroxysmal positional vertigo. Otol Neurotol [Internet]. 2005 Jul [cited 2021 Jul 27];26(4):704–10. Available from: https://pubmed.ncbi.nlm.nih.gov/16015173/
  • Nuti D, Vannucchi P, Pagnini P. Benign paroxysmal positional vertigo of the horizontal canal: a form of canalolithiasis with variable clinical features. J Vestib Res [Internet]. 1996 May 1 [cited 2021 Jul 27];6(3):173–84. Available from: https://europepmc.org/article/med/8744525
  • Minguez-Zuazo A, Grande-Alonso M, Saiz BM, Touche R La, Lara SL. Therapeutic patient education and exercise therapy in patients with cervicogenic dizziness: a prospective case series clinical study. J Exerc Rehabil. 2016 Jun 30;12(3):216–25.
  • Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: Implications for assessment and management. J Orthop Sports Phys Ther. 2009;39(5):364–77. 
  • Reid SA, Callister R, Katekar MG, Treleaven JM. Utility of a brief assessment tool developed from the Dizziness Handicap Inventory to screen for Cervicogenic dizziness: A case control study. Musculoskelet Sci Pract. 2017 Aug 1;30:42–8. 
  • Caldara B, Asenzo AI, Brusotti Paglia G, Ferreri E, Gomez RS, Laiz MM, et al. Cross-cultural Adaptation and Validation of the Dizziness Handicap Inventory: Argentine Version. Acta Otorrinolaringol (English Ed. 2012 Mar 1;63(2):106–14. 
  • Farmer P, Snodgrass SJ, Buxton AJ, Rivett DA. An investigation of cervical spinal posture in cervicogenic headache. Phys Ther [Internet]. 2015 [cited 2021 Jul 25];95(2):212–22. Available from: https://pubmed.ncbi.nlm.nih.gov/25301967/
  • Liang Z, Galea O, Thomas L, Jull G, Treleaven J. Cervical musculoskeletal impairments in migraine and tension type headache: A systematic review and meta-analysis. Musculoskelet Sci Pract [Internet]. 2019 Jul 1 [cited 2021 Jul 25];42:67–83. Available from: https://pubmed.ncbi.nlm.nih.gov/31054485/
  • Do TP, Remmers A, Schytz HW, Schankin C, Nelson SE, Obermann M, et al. Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list. Neurology [Internet]. 2019 Jan 15 [cited 2021 Jul 25];92(3):134–44. Available from: https://pubmed.ncbi.nlm.nih.gov/30587518/
  • Bogduk N. Cervicogenic headache: anatomic basis and pathophysiologic mechanisms. Curr Pain Headache Rep [Internet]. 2001 [cited 2021 Jul 25];5(4):382–6. Available from: https://pubmed.ncbi.nlm.nih.gov/11403743/
  • Suvarnnato T, Puntumetakul R, Uthaikhup S, Boucaut R. Effect of specific deep cervical muscle exercises on functional disability, pain intensity, craniovertebral angle, and neck-muscle strength in chronic mechanical neck pain: a randomized controlled trial. J Pain Res [Internet]. 2019 [cited 2021 Jul 24];12:915. Available from: /pmc/articles/PMC6411318/
  • Wong J, Côté P, Quesnele JJ, Stern PJ, Mior SA. The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature. Spine J [Internet]. 2014 Aug 1 [cited 2021 Jul 24];14(8):1781–9. Available from: https://pubmed.ncbi.nlm.nih.gov/24614255/
  • Wheeler AH, Goolkasian P, Baird AC, Darden B V. Development of the Neck Pain and Disability Scale. Item analysis, face, and criterion-related validity. Spine (Phila Pa 1976) [Internet]. 1999 Jul 1 [cited 2021 Jul 22];24(13):1290–4. Available from: https://pubmed.ncbi.nlm.nih.gov/10404569/
  • Bolton JE, Humphreys BK. The Bournemouth Questionnaire: A short-form comprehensive outcome measure. II. Psychometric properties in neck pain patients. J Manipulative Physiol Ther. 2002;25(3):141–8. 
  • Jacobson G, Newman C. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg [Internet]. 1990 [cited 2021 Jul 22];116(4):424–7. Available from: https://pubmed.ncbi.nlm.nih.gov/2317323/