Effect of Cervical Spine Mobilization on Functional Status of Vertebral Artery Blood Flow in Vertebro Basilary Insufficiency Patients

Abstract

Vertebro-basilary insufficiency (VBI) refers to temporary or permanent reduction or interruption of blood supply through the vertebral arteries of Right and Left side of neck and the basilar artery to the hind brain.There is a close relationship between the vertebral artery and cervical spine. Vertigo is associated with the pathology of upper segment of cervical spine.The most important factors are micro and macro trauma to cervical spine structures, old age people, osteophytes, oedema and muscle spasm resulting from degeneration that causes direct pressure on the vertebral artery (VA) and results in reduction in blood flow of VA. With the movement of the head especially in the direction of rotation and hyperextension, compression of the artery can be more obvious. newlineThis study aims to design and emphasize on a combined therapeutic approach for VBI which can improve the Blood flow velocity and Dizziness and pain. The study had conducted on 42 asymptomatic and 83 patients with VBI symptoms. In this randomized control trial, 37 VBI patients received manual mobilization along with exercises regime whilst 34 subjects received exercises session alone for the period of 6 weeks. The result of the present study showed a significant increase of blood flow velocity (Peak Systolic velocity and End diastolic velocity) in the subjects who received combined manual therapy intervention as compared to those who didn t received manual mobilization. There is also a significant decrease of Vertigo level measured with Dizziness Handicap Inventory (DHI) in manual therapy group. Similarly there is statistically significant improvement in Neck pain rating scale (NPRS) in both groups because TENS and postural correction exercises were given in both groups. The present study concluded that a holistic approachis necessary for the treatment of an individual presenting with cervical dysfunctions associated with dizziness/vertigo.