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

Abstract

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.

Stimulated cervical afferent input increases postural instability in older people with chronic neck pain: a cross-sectional study

“…A study found that young patients with chronic neck pain had greater increases in postural sway with neck torsion compared to patients with unilateral vestibular loss and asymptomatic controls [ 9 ]. A recent study has also demonstrated the relationship between neck position sense and balance in the neck torsion maneuver [ 10 ], which supports a proposed mechanism of cervical-driven postural balance deficits. Thus, the neck torsion maneuver may further identify altered cervical afferent causes of impaired standing balance in older people with chronic neck pain.…”

Cervicocephalic kinaesthesia reveals novel subgroups of motor control impairments in patients with neck pain

“…While position sense tests commonly apply parameters of variable, constant and absolute error 9 , 10 movement sense tests apply more diverse parameters such as smoothness of movement 11 , accuracy of head and neck movement 2 , 12 , 13 directional accuracy 14 , mean and peak velocity of head movement 12 , 13 , 15 time to peak velocity 12 , 16 and others, although all these are not consistently applied throughout the literature. Some studies apply limited amount of parameters 11 , 13 , 17 , while other studies apply numerous parameters simultaneously 18 – 20 which raises the concern of addressing different characteristics of kinaesthetic sensibility, however to our knowledge this has not yet been addressed.…”