Effects of Cervical Mobilization on Dizziness, Balance, and Joint Position Sense in Patients With Meniere's Disease

The study will employ a stratified randomization method. Patients presenting to the Afyonkarahisar Health Sciences University Health Application and Research Center, Ear, Nose, and Throat Outpatient Clinic, with a definitive diagnosis of Meniere's disease, unilateral or bilateral involvement, and who consent to participate in the study will be divided into three groups. The control group will receive only their routine Betahistine. Their usual treatment will remain unchanged. The first study group will receive 20 minutes of Vestibular Rehabilitation (VR) and 10 minutes of cervical mobilization in addition to their routine Betahistine. The second study group will receive 30 minutes of VR in addition to Betahistine. The study will last 6 weeks. Participants will be assessed using a sociodemographic information questionnaire, the Dizziness Handicap Inventory (DHI), the Vertigo Symptom Scale (VSS), the Neck Disability Index (NDI), the International Tinnitus Inventory (ITI), balance assessment with the K-Force Plates, and joint position sense and proprioception assessment with the Kinvent Physio K-Move. All assessments will be conducted twice, before and after treatment.

Inclusion Criteria: * Definitive clinical diagnosis of unilateral or bilateral Meniere's disease * Age between 18 and 60 years * Presence of fluctuating symptoms or chronic imbalance for at least 3 months * Cognitive ability to participate in balance rehabilitation tasks (Mini Mental State Examination score ≥ 24) * Willingness to participate in the study and provide informed consent Exclusion Criteria: * Diagnosis of vertigo not associated with Meniere's disease * Presence of another acute medical condition * Neurological, psychological, or cognitive dysfunction * History of orthopedic surgery within the last 3 months * Planned surgical intervention during the rehabilitation program * Cervical spine instability * Acute cervical trauma * Vertebral artery insufficiency