Email updates

Keep up to date with the latest news and content from Trials and BioMed Central.

Open Access Study protocol

Physical therapy treatment in patients suffering from cervicogenic somatic tinnitus: study protocol for a randomized controlled trial

Sarah Michiels12*, Willem De Hertogh1, Steven Truijen13 and Paul Van de Heyning234

Author Affiliations

1 Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

2 Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

3 Multidisciplinary Motor Centre Antwerp, University of Antwerp, Antwerp, Belgium

4 Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium

For all author emails, please log on.

Trials 2014, 15:297  doi:10.1186/1745-6215-15-297

Published: 22 July 2014



Tinnitus occurs in a large part of the general population with prevalences ranging from 10% to 15% in an adult population. One subtype is cervicogenic somatic tinnitus, arising from cervical spine dysfunctions, justifying cervical spine assessment and treatment. This study aims to investigate the effect of a standardized physical therapy treatment, directed to the cervical spine, on tinnitus. Additionally, a second aim is to identify a subgroup within the tinnitus population that benefits from physical therapy treatment.

Methods and design

This study is designed as a randomized controlled trial with delayed treatment design. Patients with severe subjective tinnitus (Tinnitus Functional Index (TFI) between 25 and 90 points), in combination with neck complaints (Neck Bournemouth Questionnaire (NBQ) >14 points) will be recruited from the University Hospital of Antwerp.

Patients suffering from tinnitus with clear otological etiologies, severe depression, traumatic cervical spine injury, tumors, cervical spine surgery, or conditions in which physical therapy is contra-indicated, will be excluded.

After screening for eligibility, baseline data such as TFI, NBQ, and a set of cervical biomechanical and sensorimotor tests will be collected.

Patients are randomized in an immediate therapy group and in a group with a delayed start of therapy by 6 weeks.

Patients will receive physical therapy with a maximum of 12 sessions of 30 min for a 6-week program. Data from the TFI and NBQ will be collected at baseline (week 0), at the start of therapy (weeks 0 or 6), at the end of therapy (weeks 6 or 12), 6 weeks after therapy (weeks 12 or 18), and 3 months after therapy (weeks 18 or 24). Secondary outcome measures will be collected at baseline and 6 weeks after the therapy (weeks 12 or 18), as the maximal therapy effect on the cervical spine dysfunctions is expected at that moment.


This study is the first to investigate the effect of a standardized physical therapy treatment protocol on somatic tinnitus with a prospective comparative delayed design and with blinded evaluator for baseline, end of therapy, and 6 and 12 weeks after therapy.

Trial registration

12 September 2013, NCT02016313

Tinnitus; Physical therapy; Treatment; Cervical spine