Dizziness and balance outcomes after two different postoperative rehabilitation approaches following neck surgery: analyses of a multicenter randomized controlled trial

Physiother Theory Pract. 2023 Apr;39(4):750-760. doi: 10.1080/09593985.2022.2029654. Epub 2022 Feb 13.

Abstract

Background: Dizziness and balance problems are common symptoms in patients with cervical radiculopathy.

Objective: To evaluate the effect of neck surgery postoperatively combined with either structured rehabilitation or standard approach in patients with cervical radiculopathy and dizziness and/or balance problems, and investigate factors influencing dizziness and balance at 6-month follow-up.

Methods: Individuals (n = 149) with cervical radiculopathy and dizziness and/or balance problems were randomized preoperatively to structured postoperative rehabilitation or standard postoperative approach. Outcomes were intensity of dizziness and subjective balance, and clinical measures of balance.

Results: Self-reported measures improved at three months (p ˂ 0.001 to p = .007) and the standing balance at six months (p = .008). No between-group differences. Baseline values, neck pain, and physical activity level explained 23-39% of the variance in 6-month outcomes for self-reported measures. Baseline values and physical activity level explained 71% of the variance in walking balance, and lower baseline scores were significantly associated with standing balance impairments (OR 0.876).

Conclusion: Patients improved significantly in dizziness and subjective balance intensity shortly after surgery, and in standing balance at 6 months, independent of postoperative rehabilitation. Neck pain, physical activity, and neck muscle function influenced dizziness and balance, although preoperative values and neck pain were of most importance for 6-month outcomes.

Keywords: Dizziness; balance problems; cervical radiculopathy; rehabilitation; spine surgery.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cervical Vertebrae
  • Dizziness* / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Pain* / rehabilitation
  • Neck* / surgery
  • Postoperative Care
  • Radiculopathy* / rehabilitation
  • Treatment Outcome