Clinical recognition of the role of the cervical spine in signs and symptoms of altered sensorimotor control

Abstract

Together with visual and vestibular input the cervical spine is vital for sensorimotor control of head and eye movement control, general body postural stability adjustments and co-ordination.Altered cervical input in persons with neck disorders can lead to signs and symptoms of impaired sensorimotor control across and within several domains. Clinical assessment for differential diagnosis and to direct management of cervical related altered sensorimotor control is clearly required in many patients. This applies not only to patients with neck disorders but also in patients with, for example vestibular disorders or concussion, presenting with signs and symptoms of altered sensorimotor control where the cervical spine may have a role to play.This paper explores the research and current knowledge in relation to clinical measures of cervical related sensorimotor control. The feasibility, responsiveness, comparison to gold standards and potential of clinical measures of cervical related sensorimotor control to assist in differential diagnosis are considered where relevant. Future research directions should examine the full complement of psychometric properties of tests and consideration of any relationships of these measures to pain, dizziness, trauma and functional implications. Development of other measures as well as use in assessing response post management are also important directions.These clinical measures, along with a skilled interview and cervical musculoskeletal examination will enable clinicians to recognise and manage impaired cervical sensorimotor control in patients with neck disorders as well as determine the role of the cervical spine in many patients presenting with signs and symptoms of altered sensorimotor control.