Cervicocephalic Kinesthetic Sensibility Research Articles

Relationship between Cervicocephalic Kinesthetic Sensibility Measured during Dynamic Unpredictable Head Movements and Eye Movement Control or Postural Balance in Neck Pain Patients.

Cervical afferent input is believed to affect postural balance and oculomotor control in neck pain patients, but its relationship to cervicocephalic kinesthesia, describing movement sense, has not yet been studied. The aim of this study was to analyze the relationship of two aspects of cervicocephalic kinesthesia to postural balance and oculomotor control in neck torsion positions. Forty-three idiopathic neck pain patients referred from orthopedic outpatient clinics and forty-two asymptomatic controls were enrolled in the study. A force plate was used to measure center-of-pressure movements during parallel stances under neutral and neck torsion maneuvers. Video-oculography was used to assess eye movements during smooth pursuit neck torsion test (SPNTT), while kinesthetic awareness was measured using the Butterfly test and head-to-neutral relocation test. Multiple regression was used to describe relationships between tests. Body sway in the anterior–posterior direction was related to Butterfly parameters but less to the head-to-neutral test. A medium relationship between Butterfly parameters and gain during SPNTT, with less SPNT-difference, was observed, but not for the head-to-neutral test. It can be concluded that specific aspect of neck kinesthetic functions (i.e., movement sense) importantly contributes towards oculomotor and balance control, which is more evident under neck torsion positions in neck pain patients, but is less pronounced in asymptomatic individuals.

Reliability and Validity of a Mobile Device for Assessing Head Control Ability

Head control ability assessed by the cervicocephalic kinesthetic sensibility test has been widely used as an important indicator for the diagnosis or treatment of cervical disorders. However, a reliable and handy device to measure head control has not been developed. This study aimed to compare the capability to quantify the cervicocephalic kinesthetic sensibility between an ultrasound-based motion capture system and an inertial measurement unit-based (IMU-based) mobile device with the ultimate goal of developing a clinically-useful assessment tool. Thirty-five young healthy volunteers were recruited in this study. The subjects were asked to perform the clinical cervicocephalic kinesthetic sensibility test in a head-to-neutral reposition procedure. The maximal range of motion and the reposition test in the cervical flexion, extension, right rotation, and left rotation directions were analyzed. After 5–7 days, the experimental procedure was repeated for the between-day retest measurement. No significant differences in cervical maximal range of motion and head reposition errors between the two devices were found. The intra-rater reliability of both ranged from good to excellent for the within-day and between-day measurements. The correlation between the two devices was also high, with r-values higher than 0.7 in all movement directions. The IMU-based mobile device shows the potential to be a reliable and feasible head assessment device. Further study is warranted to extend its applications for clinical examination.

Cervicocephalic kinesthetic sensibility in patients with whiplash injury

This study investigated cervicocephalic kinesthetic sensibility in patients with whiplash injury and the effects of a rehabilitation programme. Fourteen patients with a whiplash injury and 34 healthy subjects participated in this study. The ability to appreciate both movement and the position of the head with respect to the trunk was investigated. Active head repositioning was significantly less precise in the whiplash subjects compared to the control group. Repositioning was more precise in whiplash subjects after the 5-week rehabilitation programme. There was no correlation between error of repositioning in patients and pain intensity. It is probable that cervicocephalic kinesthesia is linked to sensory information from the extensive muscular and articular proprioceptive system. A flexion-extension injury to the neck may result in dysfunction of this system.

Effects of Neck Taping in the Treatment of Hemispatial Neglect in Chronic Stroke Patients: A Pilot, Single Blind, Randomized Controlled Trial.

Background and objectives: Hemispatial neglect is a common consequence of stroke, with an estimated incidence of 23%. Interventions for treating hemispatial neglect may be categorized as either top-down or bottom-up processing. The aim of top-down approaches is to train the person to voluntarily compensate for their neglect. Such approaches require awareness of the disorder and a high level of active participation by the patient. Differently, bottom-up approaches are based on manipulation of a patient’s sensory environment and so require less awareness of behavioral bias. In line with the latter, it is conceivable that elastic therapeutic taping applied to the left neck surface may provide bottom-up inputs that reduce hemispatial neglect symptoms. The aim of this study was to assess the effect of therapeutic neck taping on visuo-spatial abilities, neck motion, and kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Materials and Methods: After randomization, 12 chronic stroke patients with hemispatial neglect received 30 consecutive days of real (treatment group) or sham (control group) neck taping. The outcomes were as follows: Stars Cancellation Test; neck active range of motion; Letter Cancellation Test; Comb and Razor Test; Cervical Joint Position Error Test evaluated before and after one month of taping. Results: Between-group comparison showed significant differences only for the Cervical Joint Position Error Test after treatment (p = 0.009). Conclusions: Our preliminary findings support the hypothesis that neck taping might improve cervicocephalic kinesthetic sensibility in chronic stroke patients with hemispatial neglect. Further studies are needed to strengthen our results and better investigate the effects of elastic therapeutic taping on visuo-spatial abilities in stroke patients with hemispatial neglect.

Changes in Cervicocephalic Kinesthetic Sensibility, Widespread Pressure Pain Sensitivity, and Neck Pain After Cervical Thrust Manipulation in Patients With Chronic Mechanical Neck Pain: A Randomized Clinical Trial

ObjectiveThe purpose of the current randomized clinical trial was to examine the effects of cervical thrust manipulation or sham manipulation on cervicocephalic kinaesthetic sense, pain, pain-related disability, and pressure pain sensitivity in patients with mechanical neck pain. MethodsFifty-four individuals with neck pain were randomly assigned to receive either a cervical manipulation (right or left) or a sham manipulation. Immediate outcomes included cervical kinesthetic sense as assessed by joint position sense error (JPSE) and pressure pain thresholds (PPTs). At 1 week, neck pain intensity (numerical pain rate scale) and neck pain-related disability (Neck Disability Index [NDI]) outcomes were also collected. ResultsThe mixed-model analysis of covariance revealed a significant group × time interaction in favor of the cervical thrust manipulation group for the JPSE on rotation and extension. There was also a significant interaction for changes in PPTs at C5 to C6 and tibialis anterior. At the 1-week follow-up, a significant interaction existed for neck-related disability but not for neck pain at rest, worst pain, or lowest pain experienced the preceding week. ConclusionsOur results suggest that cervical spine thrust manipulation improves JPSE, PPT and NDI in participants with chronic mechanical neck pain. Furthermore, changes in JPSE and NDI were large and surpass published minimal detectable changes for these outcome measures. In addition, the effect sizes of PPTs were medium; however, only C5 to C6 zygapophyseal joint exceeded the minimal detectable change. In contrast, cervical thrust manipulation did not improve neck pain intensity at 1 week after the intervention.

The effect of normalizing the sagittal cervical configuration on dizziness, neck pain, and cervicocephalic kinesthetic sensibility: a 1-year randomized controlled study.

Cervicogenic dizziness is a disabling condition commonly associated with cervical dysfunction. Although the growing interest with the importance of normal sagittal configuration of cervical spine, the missing component in the management of cervicogenic dizziness might be altered structural alignment of the cervical spinal region itself. To investigate the immediate and long-term effects of a 1-year multimodal program, with the addition of cervical lordosis restoration and anterior head translation (AHT) correction, on the severity of dizziness, disability, cervicocephalic kinesthetic sensibility, and cervical pain in patients with cervicogenic dizziness. A randomized controlled study with a 1 year and 10 weeks' follow-up. University research laboratory. Seventy-two patients (25 female) between 40 and 55 years with cervicogenic dizziness, a definite hypolordotic cervical spine and AHT posture were randomly assigned to the control or an experimental group. Both groups received the multimodal program; additionally, the experimental group received the Denneroll™ cervical traction. Outcome measures included AHT distance, cervical lordosis, dizziness handicap inventory (DHI), severity of dizziness, dizziness frequency, head repositioning accuracy (HRA) and cervical pain. Measures were assessed at three time intervals: baseline, 10 weeks, and follow-up at 1 year and 10 weeks. Significant group × time effects at both the 10 week post treatment and the 1-year follow-up were identified favoring the experimental group for measures of cervical lordosis (P<0.0005) and anterior head translation (P<0.0005). At 10 weeks, the between group analysis showed equal improvements in dizziness outcome measures, pain intensity, and HRA; DHI scale (P=0.5), severity of dizziness (P=0.2), dizziness frequency (P=0.09), HRA (P=0.1) and neck pain (P=0.3). At 1-year follow-up, the between-group analysis identified statistically significant differences for all of the measured variables including anterior head translation (2.4 cm [-2.3;-1.8], P<0.0005), cervical lordosis (-14.4° [-11.6;-8.3], P<0.0005), dizziness handicap inventory (29.9 [-34.4;-29.9], P<0.0005), severity of dizziness (5.4 [-5.9;-4.9], P<0.0005), dizziness frequency (2.6 [-3.1;-2.5], P<0.0005), HRA for right rotation (2.8 [-3.9;-3.3], P<0.005), HRA for left rotation (3.1 [-3.5;-3.4, P<0.0005], neck pain (4.97 [-5.3;-4.3], P<0.0005); indicating greater improvements in the experimental group. The addition of Denneroll™ cervical extension traction to a multimodal program positively affected pain, cervicocephalic kinesthetic sensibility, dizziness management outcomes at long-term follow-up. Appropriate physical therapy rehabilitation for cervicogenic dizziness should include structural rehabilitation of the cervical spine (lordosis and head posture correction), as it might to lead greater and longer lasting improved function.

Effect of sitting postures and shoulder position on the cervicocephalic kinesthesia in healthy young males

Information about head orientation, position, and movement with respect to the trunk relies on the visual, vestibular, extensive muscular, and articular proprioceptive system of the neck. Various factors can affect proprioception since it is the function of afferent integration, and tuning of muscular and articular receptors. Pain, muscle fatigue, and joint position have been shown to affect proprioceptive capacity. Thus, it can be speculated that changes in body posture can alter the neck proprioception. This study was undertaken to investigate the effect of body posture on cervicocephalic kinesthetic sense in healthy subjects. Cervicocephalic kinesthetic sensibility was measured by the kinesthetic sensibility test in healthy young adults while in (a) habitual slouched sitting position with arms hanging by the side (SS), (b) habitual slouched sitting position with arms unloaded (supported) (SS-AS), and (c) upright sitting position with arms hanging by the side (US) during maximum and 30 degree right, left rotations, flexion, and extension. Thirty healthy male adults (mean age 27.83; SD 3.41) volunteered for this study. The least mean error was found for the SS-AS position (0.48; SD 0.24), followed by SS (0.60; SD 0.43) and US (0.96; SD 0.71), respectively. For all test conditions, there was significant difference in mean absolute error while head repositioning from maximum and 30 degree rotation during SS and SS-AS positions (p < 0.05). In conclusion, body posture can affect the proprioception function of the neck. Supporting the upper extremities in such a way that their weight is unloaded, which leads to reduction in the tension between the neck and shoulder girdle, can improve cervicocephalic kinesthetic sense in both the horizontal and vertical planes. The findings of this study can be implemented in people who have to do repeated arm and neck movements, by using ergonomically effective chairs with proper arm supports. This might help in prevention and treatment of neck pain.

Cervicocephalic kinesthetic sensibility and postural balance in patients with nontraumatic chronic neck pain – a pilot study

BackgroundAlthough cervical pain is widespread, most victims are only mildly and occasionally affected. A minority, however, suffer chronic pain and/or functional impairments. Although there is abundant literature regarding nontraumatic neck pain, little focuses on diagnostic criteria. During the last decade, research on neck pain has been designed to evaluate underlying pathophysiological mechanisms, without noteworthy success. Independent researchers have investigated postural balance and cervicocephalic kinesthetic sensibility among patients with chronic neck pain, and have (in most cases) concluded the source of the problem is a reduced ability in the neck's proprioceptive system. Here, we investigated cervicocephalic kinesthetic sensibility and postural balance among patients with nontraumatic chronic neck pain.MethodsOurs was a two-group, observational pilot study of patients with complaints of continuous neck pain during the 3 months prior to recruitment. Thirteen patients with chronic neck pain of nontraumatic origin were recruited from an institutional outpatient clinic. Sixteen healthy persons were recruited as a control group. Cervicocephalic kinesthetic sensibility was assessed by exploring head repositioning accuracy and postural balance was measured with computerized static posturography.ResultsParameters of cervicocephalic kinesthetic sensibility were not reduced. However, in one of six test movements (flexion), global repositioning errors were significantly larger in the experimental group than in the control group (p < .05). Measurements did not demonstrate any general impaired postural balance, and varied substantially among participants in both groups.ConclusionIn patients with nontraumatic chronic neck pain, we found statistically significant global repositioning errors in only one of six test movements. In this cohort, we found no evidence of impaired postural balance.Head repositioning accuracy and computerized static posturography are imperfect measures of functional proprioceptive impairments. Validity of (and procedures for using) these instruments demand further investigation.Trial registrationCurrent Controlled Trials ISRCTN96873990

Untersuchungen zur Kopf-Körper-Koordination

In the assessment of vertigo patients with suspected cervicocephalic somatosensory deficit, the studies published thus far have focused on reflectory systems like the cervico-ocular reflex or the postural systems. Our study examines the cervicocephalic kinesthetic sensibility of head and body coordination. We therefore introduce two preliminary test series: the "subjective zero chin-knee-angle of the occipital joints" and the "saccadic repositioning during trunk rotation". Subjective recordings of dizziness complaints were done using the Dizziness Handicap Inventory. The study population consisted of 24 patients with palpatory cervicocephalic somatosensory deficit (group I) and 23 patients with a central vestibular compensated unilateral vestibular deficit (group II). Twenty-two healthy patients served as controls. The aim of the study is to provide a detailed examination of the "subjective zero chin-knee-angle of the occipital joints" as well as a detailed discussion of "saccadic repositioning with trunk rotation" by three-dimensional videooculography (3D-VOG). We were able to separate patients with a cervicocephalic somatosensory deficit with the first test procedure and differentiate them from groups II and III. The second test procedure shows a significant difference between groups I and III. We conclude from the group difference that the recording of cervicocephalic kinesthetic sensibility is a further indication of disturbed cervical proprioception.

Association between cervicocephalic kinesthetic sensibility and frequency of subclinical neck pain

Although impaired neck proprioception has been demonstrated in patients with chronic neck pain, previous studies have not consistently shown any association between pain intensity and proprioceptive performance. We therefore investigated whether temporal aspects of pain are associated with cervicocephalic kinesthetic sensibility. One hundred and twenty-seven adults with or without subclinical neck pain undertook two tasks, repositioning their heads to the neutral head position (head-to-NHP) and target position (head-to-target) in sagittal and transverse plane. Absolute error was calculated from position data recorded by an ultrasound-based motion analysis system. Pain frequency, duration, and intensity were evaluated using a questionnaire. A mixed effects model was constructed to test the effect on reposition error by different pain factors, with age, gender and maximal cervical range of motion as covariates. A higher pain frequency was associated with greater reposition errors for all movement directions in the head-to-NHP task. No consistent effect was observed for pain intensity or duration. In the case of the head-to-target task, no consistent effect was observed for any of the three pain factors. The findings reveal that pain frequency, not the intensity or duration of pain, is associated with neck proprioception in individuals with subclinical neck pain.

Cervicocephalic kinesthetic sensibility in young and middle-aged adults with or without a history of mild neck pain

Previous research has shown that there is no significant relationship between the degree of structural degeneration of the cervical spine and neck pain. We therefore sought to investigate the potential role of sensory dysfunction in chronic neck pain. Cervicocephalic kinesthetic sensibility, expressed by how accurately an individual can reposition the head, was studied in three groups of individuals, a control group of 20 asymptomatic young adults and two groups of middle-aged adults (20 subjects in each group) with or without a history of mild neck pain. An ultrasound-based three-dimensional coordinate measuring system was used to measure the position of the head and to test the accuracy of repositioning. Constant error (indicating that the subject overshot or undershot the intended position) and root mean square errors (representing total errors of accuracy and variability) were measured during repositioning of the head to the neutral head position (Head-to-NHP) and repositioning of the head to the target (Head-to-Target) in three cardinal planes (sagittal, transverse, and frontal). Analysis of covariance (ANCOVA) was used to test the group effect, with age used as a covariate. The constant errors during repositioning from a flexed position and from an extended position to the NHP were significantly greater in the middle-aged subjects than in the control group ( β = 0.30 and β = 0.60 , respectively; P < 0.05 for both). In addition, the root mean square errors during repositioning from a flexed or extended position to the NHP were greater in the middle-aged subjects than in the control group ( β = 0.27 and β = 0.49 , respectively; P < 0.05 for both). The root mean square errors also increased during Head-to-Target in left rotation ( β = 0.24 ; P < 0.05 ), but there was no difference in the constant errors or root mean square errors during Head-to-NHP repositioning from other target positions ( P > 0.05 ). The results indicate that, after controlling for age as a covariate, there was no group effect. Thus, age appears to have a profound effect on an individual's ability to accurately reposition the head toward the neutral position in the sagittal plane and repositioning the head toward left rotation. A history of mild chronic neck pain alone had no significant effect on cervicocephalic kinesthetic sensibility.

Improvement After Chiropractic Care in Cervicocephalic Kinesthetic Sensibility and Subjective Pain Intensity in Patients with Nontraumatic Chronic Neck Pain

Objective The objective of this study was to examine alteration in head repositioning accuracy (HRA), range of motion, and pain intensity in patients with chronic cervical pain syndrome without a history of cervical trauma. Methods The study was a prospective, randomized, controlled trial. Forty-one patients with chronic cervical pain were randomly assigned to either a control group or a chiropractic treatment group. All patients were clinically examined, given general information on cervical pain, and provided with training instructions based on the clinical evaluation. The treatment included sessions with high-velocity and low-amplitude manipulation, proprioceptive neuromuscular facilitation, ischemic compression of myofascial trigger points, and spinal rehabilitation exercises aiming to normalize cervical range of motion (CROM) and HRA. Subjective pain intensity, cervical kinesthetic sensibility, and CROM were recorded before and after the study period. Results There was no difference between the treatment patients and the control subjects at the beginning with regard to age, sex, subjective pain intensity, range of motion, and HRA. At the 5-week follow-up, the treatment patients showed significant reductions in pain and improvement of all HRA aspects measured whereas the control subjects did not show any reduction in pain and improvement in only one HRA aspect. No significant difference was detected in CROM. Conclusions The results of this study suggest that chiropractic care can be effective in influencing the complex process of proprioceptive sensibility and pain of cervical origin. Short, specific chiropractic treatment programs with proper patient information may alter the course of chronic cervical pain.

Test–retest reliability of cervicocephalic kinesthetic sensibility in three cardinal planes

The test–retest reliability of both the head-to-neutral head position (NHP) and head-to-target repositioning tests in three cardinal planes has been examined in this study. Twenty young adults underwent both head repositioning tests and retests with 10 min rest intervals. Root mean square error (RMSE, total error), constant error (CE, directional bias), variable error (VE, variability), and standard error of measurement (SEM) were calculated from the position data recorded by an ultrasound-based motion analysis system. Intra-class correlation coefficients (ICC) were used to examine reliability. The results showed fair to excellent reliability of RMSE during head-to-NHP (ICC=0.45–0.80) and head-to-target tests (ICC=0.42–0.90), except during the head-to-NHP test (ICC=0.29) from a head extended position. Low reliability of VE associated with the neck motion toward left side bending indicated a direction-dependent effect. The SEM of RMSE (0.7–2.6°), CE (0.3–4.0°) and VE (0.4–1.5°) indicated an acceptable range of error. The present study indicated acceptable and reliable RMSE measurements with a motion analysis system in healthy young adults. Furthermore, examining the CE and VE could contribute to the interpretation of whether the subject performed the reposition tests with directional bias and repositioning variability, respectively.

A new clinical test for cervicocephalic kinesthetic sensibility: “the fly”

Kristjansson E, Hardardottir L, Asmundardottir M, Gudmundsson K. A new clinical test for cervicocephalic kinesthetic sensibility: “The Fly.” Arch Phys Med Rehabil 2004;85:490–5. Objective To investigate the reliability and discriminative ability of a new test designed to detect accuracy of neck movements. Design Repeated-measures. Case-control. Setting University musculoskeletal research clinic in Iceland. Participants Twenty women (mean age ± standard deviation [SD], 30.8±9.1y; range, 18–49y) with chronic whiplash-associated disorders (WAD) grades I and II (duration, 6mo–6y), with current pain score on a visual analog scale of 46.8±21.8, and a disability score on the Northwick Park Neck Pain Disability Index of 45%±14%. Twenty asymptomatic women (mean age ± SD, 29.3±8.6y; range, 18–48y) with no history of whiplash or insidious onset neck pain served as controls. Intervention A slowly moving object appeared on a computer screen and traced an unpredictable movement path that the subjects were required to follow by moving their heads. Three randomly ordered movement patterns were tested. Main outcome measure A new software program connected to a 3Space Fastrak system was used to measure the mean absolute error (in millimeters) of 3 trials in each movement pattern. Results The mean differences (±2 SD) between days 1 and 2 were .01±.64mm for the asymptomatic group and .33±1.80mm for the WAD group. The between-day intraclass correlation coefficients were between .60 and .77 for the asymptomatic group and .79 and .86 for the WAD group. Repeated-measures analysis of variance revealed a significant difference between groups ( P=.02). The Tukey post hoc test showed significant between-group differences for each movement pattern ( P≤.05). In each successive trial, a slight improvement for the asymptomatic group and a slight worsening for the WAD group were detected. Conclusions Better reliability was detected for the asymptomatic group than for the WAD group. The test could discriminate between the asymptomatic group versus the chronic WAD group.

Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain

Rix GD, Bagust J. Cervicocephalic kinesthetic sensibility in patients with chronic, nontraumatic cervical spine pain. Arch Phys Med Rehabil 2001;82:911-9. Objective: To investigate cervicocephalic kinesthetic sensibility (head repositioning accuracy to subjective straight ahead) in patients with chronic, nontraumatic cervical spine pain. Design: A prospective, 2-group, observational design. Setting: An outpatient chiropractic clinic in the United Kingdom. Participants: Eleven patients (6 men, 5 women; mean age ± standard deviation, 41.1 ± 13.3yr; range, 18-55yr) with chronic, nontraumatic cervical spine pain (mean duration, 24 ± 18mo), with no evidence of cervical radiculopathy and/or myelopathy or any other neurologic disorder. Eleven asymptomatic, unimpaired volunteers (5 men, 6 women; mean age, 39.3 ± 10.3yr; range, 28-54yr) with no history of whiplash or other cervical spine injury or pain served as controls. Main Outcome Measures: Cervicocephalic kinesthetic sensibility was investigated by testing the ability of blindfolded participants to relocate accurately the head on the trunk, to a subjective straight-ahead position, after a near-maximal active movement of the head in the horizontal or vertical plane. The active cervical range of motion and the duration and intensity of neck pain were also recorded. Results: Mann-Whitney U testing indicated that the patient (P) group was no less accurate in head repositioning than the control (C) group for all movement directions except flexion (median global positioning error [95% confidence interval], P = 5.7° [5.03-9.10], C = 4.2° [3.17-5.32]; p <.05). Conclusions: Nontraumatic neck pain patients show little evidence of impaired cervicocephalic kinesthetic sensibility. These results contrast with studies of chronic cervical pain patients in which the origin was not controlled or involved a cervical whiplash injury. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury

Objective: To investigate cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury. Design: A 2-year review of consecutive patients admitted to the emergency unit after whiplash injury. Setting: An otorhinolaryngology department. Patients and Subjects: Twenty-seven consecutive patients with diagnosed whiplash injury (14 men and 13 women, mean age, 33.8yrs [range, 18 to 66yrs]). The controls were healthy subjects without a history of whiplash injury. Main Outcome Measures: Oculomotor function was tested at 2 months and at 2 years after whiplash injury. The ability to appreciate both movement and head position was studied. Active range of cervical motion was measured. Subjective intensity of neck pain and major medical symptoms were recorded. Results: Active head repositioning was significantly less precise in the whiplash subjects than in the control group. Failures in oculomotor functions were observed in 62% of subjects. Significant correlations occurred between smooth pursuit tests and active cervical range of motion. Correlations also were established between the oculomotor test and the kinesthetic sensibility test. Conclusion: The results suggest that restricted cervical movements and changes in the quality of proprioceptive information from the cervical spine region affect voluntary eye movements. A flexion/extension injury to the neck may result in dysfunction of the proprioceptive system. Oculomotor dysfunction after neck trauma might be related to cervical afferent input disturbances.

Cervicocephalic kinesthetic sensibility in patients with whiplash injury

This study investigated cervicocephalic kinesthetic sensibility in patients with whiplash injury and the effects of a rehabilitation programme. Fourteen patients with a whiplash injury and 34 healthy subjects participated in this study. The ability to appreciate both movement and the position of the head with respect to the trunk was investigated. Active head repositioning was significantly less precise in the whiplash subjects compared to the control group. Repositioning was more precise in whiplash subjects after the 5-week rehabilitation programme. There was no correlation between error of repositioning in patients and pain intensity. It is probable that cervicocephalic kinesthesia is linked to sensory information from the extensive muscular and articular proprioceptive system. A flexion-extension injury to the neck may result in dysfunction of this system.

Cervicocephalic kinesthetic sensibility in patients with cervical pain.

Head orientation in space makes use of multiple sensory afferents, among which the cervical proprioceptive cues could play a predominant role. To quantify the alteration of neck proprioception in patients with cervical pathology, we proposed a test for the clinical evaluation of the ability to relocate the head on the trunk after an active head movement, for 30 healthy subjects and 30 patients with cervical pain. The data demonstrated that this ability was significantly poorer in the patient group, indicating an alteration in neck proprioception. This test permits a discriminant classification of healthy and sick subjects, justifies proprioceptive rehabilitation programs, and allows a quantitative evaluation of their results.