ORIGINAL ARTICLE
EFFECTS OF COMPLEX NECK THERAPY – KINESIOTHERAPY AND INTERSPINAL MUSCLES MASSAGE – ON TINNITUS
Shikha Spencer 1, A-C,E-F
,
 
Magdalena Sereda 2,3, D-F
,
 
,
 
Jurek Olszewski 1, A,D,G
,
 
,
 
,
 
,
 
Jan Bulla 5,6, C
,
 
 
 
 
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1
Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, Poland
 
2
Nottingham Biomedical Research Centre, National Institute for Health and Care Research (NIHR), Nottingham, United Kingdom
 
3
Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, United Kingdom
 
4
Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Teaching Hospital of the Medical University of Lodz – Central Veterans’ Hospital, Lodz, Poland
 
5
Department of Mathematics, University of Bergen, Norway
 
6
Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
 
 
Submission date: 2023-05-21
 
 
Acceptance date: 2023-06-30
 
 
Online publication date: 2023-09-21
 
 
Publication date: 2023-09-21
 
 
Corresponding author
Marzena Mielczarek   

Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland
 
 
J Hear Sci 2023;13(3):19-30
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Past studies have shown connections between the somatosensory system (the neck and temporomandibular joint region) and the auditory system. It is therefore likely that tinnitus patients might benefit from neck therapy. The aim of this study was to investigate the effects of physiotherapy of the neck, comprising cervical spine kinesiotherapy and interspinal muscles massage, on subjective tinnitus. We also investigated the effects of the therapy on the range of cervical spine motion and cervical muscles tension.

Material and methods:
This was a non-randomised controlled trial. Adult patients with chronic subjective tinnitus (n = 118) were enrolled in an intervention group and received 10 sessions, over 2 weeks, of neck therapy comprising active exercises, massage of the cervical interspinal muscles, and post-isometric relaxation exercises. There was also a control group (waiting list). The effects of the therapy on tinnitus were assessed at baseline, immediate post-treatment, and follow-up (2 weeks after the end of therapy) using the Polish Tinnitus Functional Index (TFI-Pl, primary outcome measure), a visual analogue scale (VAS) of tinnitus loudness, and the Polish Tinnitus Handicap Inventory (THIPl). Effects of therapy on neck were assessed using two measures: the range of cervical spine movement (cervical flexion, cervical rotation, and cervical side bending measured in cm using a tape measure); and muscle tension – assessed by palpation and graded using a scale of either 0 (normal) or 1 (increased).

Results:
In the intervention group, the mean TFI score was reduced significantly from baseline (mean = 52.6, SD = 20.4) to post treatment (mean = 40.9, SD = 19.0, p < 0.001) and at follow-up (mean = 40.4, SD = 21.1, linear mixed model). In the control group, mean TFI score did not change significantly from baseline (mean = 46.8, SD = 20.1) to post treatment (mean = 45.8, SD = 40.9) and follow-up (mean = 45.2, SD = 26.2, linear mixed model). Improvement in tinnitus in the intervention group was accompanied by a reduction in cervical muscles tension and improvement in the range of cervical spine motion.

Conclusions:
Complex neck therapy of the neck appears to be a promising intervention for tinnitus treatment. Further randomised studies are needed to confirm the positive effects of the therapy on tinnitus and explore the mechanisms leading to improvement.

 
REFERENCES (63)
1.
De Ridder D, Schlee W, Vanneste S, Londero A, Weisz N, Kleinjung T et al. Tinnitus and tinnitus disorder: theoretical and operational definitions (an international multidisciplinary proposal). Prog Brain Res, 2021; 260: 1–25. https:/doi.org/10.1016/bs.pbr.2020.12.002.
 
2.
Han BI, Lee HW, Kim TY, Lim JS, Shin KS. Tinnitus: characteristics, causes, mechanisms, and treatments. J Clin Neurol, 2009; 5(1): 11–9. https://doi.org/10.3988/jcn.20....
 
3.
Langguth B, Kreuzer PM, Kleinjung T, De Ridder D. Tinnitus: causes and clinical management. Lancet Neurol, 2013; 12(9): 920–30. https://doi.org/10.1016/S1474-....
 
4.
Baguley D, McFerran D, Hall D. Tinnitus. Lancet, 2013; 382: 1600–7. https://doi.org/10.1016/S0140-....
 
5.
Jarach CM, Lugo A, Scala M, van den Brandt PA, Cederroth CR, Odone A et al. Global prevalence and incidence of tinnitus. JAMA Neurol, 2022; 79(9): 888–900. https://doi.org/10.1001/jamane....
 
6.
Haider HF, Ribeiro SF, Hoare DJ, Fialho G, Hall DA, Antunes M et al. Quality of life and psychological distress in Portuguese older individuals with tinnitus. Brain Sci, 2021; 11(7): 953. https://doi.org/10.3390/brains....
 
7.
Hall DA, Fackrell K, Li AB, Thavayogan R, Smith S, Kennedy V, et al. A narrative synthesis of research evidence for tinnitus-related complaints as reported by patients and their significant others. Health Qual Life Outcomes, 2018; 16(1): 61. https://doi.org/10.1186/s12955....
 
8.
Makar SK. Etiology and pathophysiology of tinnitus: a systematic review. Int Tinnitus J, 2021; 25(1): 76–86. https://doi.org/10.5935/0946-5....
 
9.
Ralli M, Greco A, Turchetta R, Altissimi G, de Vincentiis M, Cianfrone G. Somatosensory tinnitus: current evidence and future perspectives. J Int Med Res, 2017; 45: 933–47. https://doi.org/10.1177/030006....
 
10.
Michiels S, Ganz Sanchez T, Oron Y, Gilles A, Haider HF, Erlandsson S et al. Diagnostic criteria for somatosensory tinnitus: a Delphi process and face-to-face meeting to establish consensus. Trends Hear, 2018; 22:2331216518796403. https://doi.org/10.1177/233121....
 
11.
Michiels S, De Hertogh W, Truijen S, Van de Heyning P. Cervical spine dysfunctions in patients with chronic subjective tinnitus. Otol Neurotol, 2015; 36(4): 741–5. https://doi.org/10.1097/MAO.00....
 
12.
Ralli M, Altissimi G, Turchetta R, Cianfrone, G. Somatic modulation of tinnitus: a review and some open questions. Otolaryngol Open J, 2016; 2: 111–4. https://doi.org/10.17140/OTLOJ....
 
13.
Itoh K, Kamiya H, Mitani A, Yasui Y, Takada M, Mizuno N. Direct projections from the dorsal column nuclei and the spinal trigeminal nuclei to the cochlear nuclei in the cat. Brain Res, 1987; 400(1): 145–50. https://doi.org/10.1016/0006-8....
 
14.
Li H, Mizuno N. Single neurons in the spinal trigeminal and dorsal column nuclei project to both the cochlear nucleus and the inferior colliculus by way of axon collaterals: a fluorescent retrograde double-labeling study in the rat. Neurosci Res, 1997; 29(2): 135–42. https://doi.org/10.1016/s0168-....
 
15.
Zhan X, Pongstaporn T, Ryugo DK. Projections of the second cervical dorsal root ganglion to the cochlear nucleus in rats. J Comp Neurol, 2006; 496(3): 335–48. https://doi.org/10.1002/cne.20....
 
16.
Koehler SD, Shore SE. Stimulus timing-dependent plasticity in dorsal cochlear nucleus is altered in tinnitus. J Neurosci, 2013; 33(50): 19647–56. https://doi.org/10.1523/jneuro....
 
17.
Wu C, Stefanescu RA, Martel DT, Shore SE. Tinnitus: maladaptive auditory-somatosensory plasticity. Hear Res, 2016; 334: 20–9. https://doi.org/10.1016/j.hear....
 
18.
Shore S, Zhou J, Koehler S. Neural mechanisms underlying somatic tinnitus. Prog Brain Res, 2007; 166: 107–23. https://doi.org/10.1016/S0079-....
 
19.
Shore SE, Roberts LE, Langguth B. Maladaptive plasticity in tinnitus: triggers, mechanisms and treatment. Nat Rev Neurol, 2016; 12: 150–60. https://doi.org/10.1038/nrneur....
 
20.
Abel MD, Levine RA. Muscle contractions and auditory perception in tinnitus patients and nonclinical subjects. Cranio, 2004; 22(3): 181–91. https://doi.org/10.1179/crn.20....
 
21.
Sanchez TG, da Silva Lima A, Brandão AL, Lorenzi MC, Bento RF. Somatic modulation of tinnitus: test reliability and results after repetitive muscle contraction training. Ann Otol Rhinol Laryngol, 2007; 116: 30–5. https://doi.org/10.1177/000348....
 
22.
Michiels S, Harrison S, Vesala M, Schlee W. The presence of physical symptoms in patients with tinnitus: international web-based survey. Interact J Med Res, 2019; 8(3): e14519. https://doi.org/10.2196/14519.
 
23.
Michiels S, Van de Heyning P, Truijen S, Hallemans A, De Hertogh W. Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus. Manual Therapy, 2016; 26: 125–31. https://doi.org/10.1016/j.math....
 
24.
Gross AR, Hoving JL, Haines TA, Goldsmith CH, Kay T, Aker P et al. A Cochrane review of manipulation and mobilization for mechanical neck disorders. Spine, 2004; 29(14): 1541–8. https://doi.org/10.1097/01.brs....
 
25.
Kay TM, Gross A, Goldsmith C, Santaguida PL, Hoving J, Brønfort G. Exercises for mechanical neck disorders. Cochrane Database Syst Rev, 2005; CD004250. https://doi.org/10.1002/146518....
 
26.
Kisner C, Borstad J, Colby LA. Therapeutic exercise: Foundations and techniques (8th ed.). Philadelphia, PA: F.A. Davis; 2023.
 
27.
Weerapong P, Hume PA, Kolt GS. The mechanisms of massage and effects on performance, muscle recovery and injury prevention: Sports Med, 2005; 35(3): 235–56. https://doi.org/10.2165/000072....
 
28.
Sherman KJ, Cherkin DC, Hawkes RJ, Miglioretti DL, Deyo, RA. Randomized trial of therapeutic massage for chronic neck pain. Clin J Pain, 2009; 25: 233–8. https://doi.org/10.1097/AJP.0b....
 
29.
Crawford C, Boyd C, Paat CF, Price A, Xenakis L, Yang E et al. The impact of massage therapy on function in pain populations: a systematic review and meta-analysis of randomized controlled trials. Part I, patients experiencing pain in the general population. Pain Med, 2016; 17(7): 1353–75. https://doi.org/10.1093/pm/pnw....
 
30.
Skillgate E, Pico-Espinosa OJ, Côté P, Jensen I, Viklund P, Bottai M et al. Effectiveness of deep tissue massage therapy, and supervised strengthening and stretching exercises for subacute or persistent disabling neck pain. The Stockholm Neck (STONE) randomized controlled trial. Musculoskelet Sci Pract, 2020; 45: 102070. https://doi.org/10.1016/j.msks....
 
31.
Clay JH, Allen L, Pounds DM. Clay and Pounds’ Basic Clinical Massage Therapy: Integrating anatomy and treatment (3rd ed.). Philadelphia: Wolters Kluwer; 2016.
 
32.
Chaitow L, Crenshaw K. Muscle Energy Techniques (3rd ed.). Saint Louis: Elsevier Health Sciences UK; 2006.
 
33.
Gibbons J. Muscle Energy Techniques: A practical guide for physical therapists (2nd ed.). Chichester, England: Lotus Publishing; 2022.
 
34.
Waxenbaum, JA, Lu M. Physiology, Muscle Energy. StatPearls Publishing 2021. Available at: https://www.ncbi.nlm.nih.gov/b... [Accessed 11.09.2022].
 
35.
Sbardella S, La Russa C, Bernetti A, Mangone M, Guarnera A, Pezzi L et al. Muscle energy technique in the rehabilitative treatment for acute and chronic non-specific neck pain: a systematic review. Healthcare (Basel), 2021; 9: 746. https://doi.org/10.3390/health....
 
36.
Michiels S, Naessens S, Van de Heyning P, Braem M, Visscher CM, Gilles A et al. The effect of physical therapy treatment in patients with subjective tinnitus: a systematic review. Front Neurosci, 2016; 10: 545. https://doi.org/10.3389/fnins.....
 
37.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry, 1961; 4: 561–71. https://doi.org/10.1001/archps....
 
38.
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Consult Clin Psychol, 1988; 56(6): 893–7. https://doi.org/10.1037//0022-....
 
39.
Wrzosek M, Szymiec E, Klemens W, Kotyło P, Schlee W, Modrzyńska M et al. Polish translation and validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index. Front Psychol, 2016; 7: 1871. https://doi.org/10.3389/fpsyg.....
 
40.
Meikle MB, Henry JA, Griest SE, Stewart BJ, Abrams HB, McArdle R et al. The Tinnitus Functional Index: development of a new clinical measure for chronic, intrusive tinnitus. Ear Hear, 2012; 33(2): 153–7. https://doi.org/10.1097/AUD.0b....
 
41.
Lewit K, Simons DG. Myofascial pain: relief by post-isometric relaxation. Arch Phys Med Rehabil, 1984; 65(8): 452–6.
 
42.
Newman CW, Jacobson GP, Spitzer JB. Development of the Tinnitus Handicap Inventory. Arch Otolaryngol Head Neck Surg, 1996; 122(2): 143–8. https://doi.org/10.1001/archot....
 
43.
Jastreboff PJ. 25 years of tinnitus retraining therapy. HNO, 2015; 63(4): 307–11. https://doi.org/10.1007/s00106....
 
44.
Adamchic I, Langguth B, Hauptmann C, Alexander Tass P. Psychometric evaluation of visual analog scale for the assessment of chronic tinnitus. Am J Audiol, 2012; 21: 215–25. https://doi.org/10.1044/1059-0...).
 
45.
Hsieh CY, Yeung BW. Active neck motion measurements with a tape measure. J Orthop Sports Phys Ther, 1986; 8(2): 88–90. https://doi.org/10.2519/jospt.....
 
46.
Asha SE, Pryor R. Validation of a method to assess range of motion of the cervical spine using a tape measure. J Manipulative Physiol Ther, 2013; 36: 538–45. https://doi.org/10.1016/j.jmpt....
 
47.
Zembaty A. Kinesiotherapy. Vol. I. Krakow: Kasper; 2003.
 
48.
Maitland GD. Palpation examination of the posterior cervical spine: the ideal, average and abnormal. Aust J Physiother, 1982; 28(3): 3–12. https://doi.org/10.1016/S0004-....
 
49.
Cro S, Morris TP, Kenward MG, Carpenter JR. Reference-based sensitivity analysis via multiple imputation for longitudinal trials with protocol deviation. Stata J, 2016; 16(2): 443–63. https://doi.org/10.1177/153686....
 
50.
Vanneste S, To WT, De Ridder D. Tinnitus and neuropathic pain share a common neural substrate in the form of specific brain connectivity and microstate profiles. Prog Neuropsychopharmacol Biol Psychiatry, 2019; 88: 388–400. https://doi.org/10.1016/j.pnpb....
 
51.
Ausland JH-L, Engdahl B, Oftedal B, Steingrímsdóttir ÓA, Nielsen CS, Hopstock LA et al. Tinnitus and associations with chronic pain: the population-based Tromsø Study (2015–2016). PLoS One, 2021; 16(3): e0247880. https://doi.org/10.1371/journa....
 
52.
De Meulemeester K, Meeus M, Dhooge I, Taevernier A, Van Elslander M, Cagnie B et al. Comparing tinnitus, pain, psychosocial and cognitive factors between patients with tinnitus and pain: a systematic review. J Psychosom Res, 2023; 168: 111201. https://doi.org/10.1016/j.jpsy....
 
53.
Sinha AG. Principles and Practice of Therapeutic Massage (3rd ed.). Delhi: Jaypee Digital; 2021. https://doi.org/10.5005/jp/boo...
 
54.
Salvo SG. Massage Therapy: Principles and practice (9th ed.). St Louis, MO: Elsevier; 2023.
 
55.
Giesler GJ. Ascending nociceptive pathways. In: Gebhart GF, Schmidt RF (eds), Encyclopedia of Pain, 2013; Springer, Berlin. https://doi.org/10.1007/978-3-....
 
56.
Faqih AI, Bedekar N, Shyam A, Sancheti P. Effects of muscle energy technique on pain, range of motion and function in patients with post-surgical elbow stiffness: a randomized controlled trial. Hong Kong Physiother J, 2019; 39(1): 25–33. https://doi.org/10.1142/S10137....
 
57.
Jeong HM, Shim J-H, Suh HR. The passive stretching, massage, and muscle energy technique effects on range of motion, strength, and pressure pain threshold in musculoskeletal neck pain of young adults. Phys Ther Rehabil, 2017; 6: 196–201. https://doi.org/10.14474/ptrs.....
 
58.
Schenk R, Adelman K, Rousselle J. The effects of muscle energy technique on cervical range of motion. J Man Manip Ther, 1994; 2: 149–55. https://doi.org/10.1179/jmt.19....
 
59.
Srikanth M, Srikumari DV, Madhavi DK. Effectiveness of muscle energy technique on pain and cervical range of motion in patients with myofascial pain in upper trapezius. Int J Physiother, 2015; 2(1): 333–40. https://doi.org/10.15621/ijphy....
 
60.
Thomas E, Cavallaro AR, Mani D, Bianco A, Palma A. The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review. Chiropr Man Therap, 2019; 27: 35. https://doi.org/1010.1186/s129...
 
61.
Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating nonspecific neck pain: a systematic review. J Back Musculoskelet Rehabil, 2017; 30(6): 1149–69. https://doi.org/10.3233/BMR-16....
 
62.
Levine RA. Somatic (craniocervical) tinnitus and the dorsal cochlear nucleus hypothesis. Am J Otolaryngol, 1999; 20(6): 351–62. https://doi.org/10.1016/S0196-...
 
63.
Levine RA, Nam EC, Oron Y, Melcher JR. Evidence for a tinnitus subgroup responsive to somatosensory based treatment modalities. Prog Brain Res, 2007; 166: 195–207. https://doi.org/10.1016/S0079-....
 
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