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Cerina V, Tesio L, Malloggi C, Rota V, Caronni A, Scarano S. Cervical Proprioception Assessed through Targeted Head Repositioning: Validation of a Clinical Test Based on Optoelectronic Measures. Brain Sci 2023; 13:brainsci13040604. [PMID: 37190569 DOI: 10.3390/brainsci13040604] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/18/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Neck proprioception is commonly assessed with head repositioning tests. In such a test, an operator rotates the head of a blindfolded individual to a target position. After returning to the rest position, the participant actively repositions the head to the target. Joint Position Error (JPE) is the angular difference between the target angle (however oriented in a 3D space) and the actively reached positions (the smaller the difference, the better the proprioception). This study aimed to validate a head-to-target (HTT) repositioning test using an optoelectronic system for also measuring the components of the JPE in the horizontal, frontal, and sagittal planes. The head movements requested by the operator consisted of 30° left-right rotations and 25° flexion-extension. The operators or subjects could not obtain these movements without modest rotations in other planes. Two operators were involved. Twenty-six healthy participants (13 women) were recruited (mean (SD): 33.4 (6.3) years). The subjects’ JPE in the requested (intended) plane of motion (JPEint-component) was a few degrees only and smaller for flexion-extensions than for left-right rotations (right rotation: 5.39° (5.29°); left rotation: 5.03° (4.51°), extension: 1.79° (3.94°); flexion: 0.54° (4.35°)). Participants’ average error in unintended planes was around 1° or less. Inter-operator consistency and agreement were high. The smallest detectable change, at p < 0.05, for JPEint-component ranged between 4.5° and 6.98°. This method of optoelectronic measurement in HTT repositioning tests provides results with good metric properties, fostering application to clinical studies.
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Affiliation(s)
- Valeria Cerina
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milan, Italy
| | - Luigi Tesio
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milan, Italy
| | - Chiara Malloggi
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milan, Italy
| | - Viviana Rota
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milan, Italy
| | - Antonio Caronni
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Stefano Scarano
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
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Cid MM, Calixtre LB, da Silva Grüninger BL, Sousa FS, Oliveira AB. Reliability of the Joint Position Sense Error Test for Women With Neck Pain and Asymptomatic Men and Women. J Manipulative Physiol Ther 2022; 45:329-336. [PMID: 36192261 DOI: 10.1016/j.jmpt.2022.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/25/2022] [Accepted: 08/24/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the intra-rater between-days reliability of the joint position sense error (JPSE) test in asymptomatic men and women, as well as in women with neck pain. METHODS Fourteen asymptomatic men and 27 women (14 asymptomatic and 13 with neck pain) participated. The JPSE test was performed during right and left cervical rotation (10 trials for each side) in 2 sessions, with at least 7 days between them. The head repositioning error during the JPSE test (in degrees) was measured and used to calculate the intra-rater between-days reliability of the test, evaluated through the intraclass correlation coefficient and Bland-Altman analyses. Independent t tests were calculated to compare the head repositioning errors of asymptomatic women and men. The minimal detectable change was also calculated. RESULTS The neck pain group showed higher intraclass correlation coefficient values (0.866 and 0.773, good reliability) compared to the asymptomatic men (0.478 and 0.403, poor reliability) and to the asymptomatic women (-0.161 and 0.504, poor and moderate reliability, respectively) for both right and left cervical rotation, respectively. Considering Bland-Altman analyses, the neck pain group showed better agreement between the measurements for right cervical rotation than the asymptomatic groups. CONCLUSION The results indicate that the methodology used to perform the JPSE test in this study may be a reliable way to assess the proprioception of women with neck pain in clinical settings.
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Affiliation(s)
- Marina Machado Cid
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Letícia Bojikian Calixtre
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Bruno Leonardo da Silva Grüninger
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Franciana Silva Sousa
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Beatriz Oliveira
- Laboratory of Clinical and Occupational Kinesiology (LACO), Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
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Mooti R, Park H. Contribution of Cervical Proprioception, Vision, and Vestibular Feedback on Reducing Dynamic Head–Trunk Orientation Error in the Yaw Direction. Front Neurosci 2022; 15:774448. [PMID: 35140583 PMCID: PMC8818861 DOI: 10.3389/fnins.2021.774448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
The contribution of cervical proprioception, vision, and vestibular feedback to the dynamic head–trunk orientation error in the yaw direction was investigated to further the understanding over the mechanism of coordination among different sensory modalities for dynamic head–trunk orientation. To test the contribution of each sensory modality, individually and together, to dynamic head–trunk orientation, 10 healthy human subjects participated in the extended cervical joint position error test, measuring the ability of repositioning the head back to the reference orientation after 45° yaw rotation of head or trunk. The error between initial and returned angles was measured. The test was repeated under eight different conditions of sensory feedback, with or without each of three sensory modalities. Each subject completed 64 trials (8 per condition) in a random order for fair comparison. No change was found in bias when one of the three modalities was missing, while variance was largest at the lack of dynamic cervical proprioception. When two of the three modalities were missing (i.e., one of the three modalities was present), both bias and variance were minimum at the presence of cervical proprioception. Additionally, both visual and vestibular feedback was redundant (i.e., no further improvement in both bias and variance), if the other one (visual or vestibular feedback) was present with dynamic cervical proprioception. In sum, the experimental results suggest that dynamic cervical proprioception is the most significant sensory modality for reducing the dynamic head–trunk orientation error in the yaw direction.
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Sung YH. Upper cervical spine dysfunction and dizziness. J Exerc Rehabil 2020; 16:385-391. [PMID: 33178639 PMCID: PMC7609854 DOI: 10.12965/jer.2040612.306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022] Open
Abstract
Although various causes of dizziness have been identified, many patients suffer from dizziness of unknown etiology and continue to visit hospitals to resolve their symptoms. Problems that occur in the ligaments or muscles of the upper cervical spine can cause confusion in proprioception. These changes can convey misinformation to the vestibular nucleus, resulting in abnormal reactions that can lead to cervicogenic dizziness (CGD). Though CGD remains controversial, it should be considered while diagnosing patients with dizziness. Understanding CGD can help create treatment strategies for them. This article suggested a relationship between the structure and function of the upper cervical spine and dizziness, and presented evaluations and treatments for the same.
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Affiliation(s)
- Yun-Hee Sung
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
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Ghamkhar L, Amiri Arimi S, Kahlaee AH. Interactive Association Between Mechanical and Sensorimotor Aspects of Cervical Extensor Muscles: Implications for Chronic Neck Pain. J Appl Biomech 2020; 36:190-197. [PMID: 32357313 DOI: 10.1123/jab.2019-0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/02/2020] [Accepted: 03/03/2020] [Indexed: 11/18/2022]
Abstract
While proprioceptive functioning of the cervical extensor muscles has been proposed to be associated with chronic neck pain (NP), the mechanism by which such impairment might contribute to NP is not clear. The aim of this cross-sectional study was to investigate the relevance of proprioception, extensor muscles size, and endurance to chronic NP. A total of 60 participants with (n = 30) or without (n = 30) chronic NP participated in this cross-sectional study. Joint repositioning error (JRE), ultrasonographic parameters of the cervical extensors, and clinical extensor endurance were assessed. Multivariate analysis of variance and logistic regression tests were used to compare the groups and test the predictive value of the dependent variables for chronic NP, respectively. Patients showed comparable JRE scores but smaller multifidus size and lower extensor endurance (Cohen d = 0.66 for both). JRE in the transverse plane (β = 1.20), multifidus muscle size (β = 0.02), and endurance (β = 0.99) were significant predictors for chronic NP odds ratio. The results found multifidus size as the most relevant factor to NP by showing both between-groups difference and considerable odds ratio. As JRE in transverse plane was not different between the groups and extensor endurance demonstrated minimal odds ratio, these 2 factors may be considered as less relevant to NP comparing multifidus muscle size.
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Affiliation(s)
- Leila Ghamkhar
- Rofeideh Rehabilitation Hospital
- University of Social Welfare and Rehabilitation Sciences
| | | | - Amir H Kahlaee
- Rofeideh Rehabilitation Hospital
- University of Social Welfare and Rehabilitation Sciences
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Qu N, Lindstrøm R, Graven-Nielsen T, Hirata RP. Experimental cervical interspinous ligament pain altered cervical joint motion during dynamic extension movement. Clin Biomech (Bristol, Avon) 2019; 65:65-72. [PMID: 30991232 DOI: 10.1016/j.clinbiomech.2019.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/26/2019] [Accepted: 04/02/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although the cervical interspinous ligament is a potential source of neck pain, the effects on cervical joint motion and pressure pain sensitivity has never been investigated. The understanding of the relationship will broaden our understanding of cervical biomechanics and improve diagnosis and treatment of neck pain. METHODS Fluoroscopy videos of cervical flexion and extension movements and pressure pain thresholds over bilateral C2/C3 and C5/C6 facet joints were collected in fifteen healthy subjects before and after injections of hypertonic and isotonic saline in C4/C5 ISL. The videos were divided into 10 even epochs and the motion of individual joints during each epoch was extracted. Joint motion parameters including anti-directional motion, pro-directional motion, total joint motion and joint motion variability were extracted across epochs. Joint motion parameters and PPTs were compared before and after injection of hypertonic and isotonic saline separately. FINDINGS Compared with baselines: hypertonic saline injection 1) decreased anti-directional motion and joint motion variability at C4/C5 (P < 0.05) and increased at C2/C3 (P < 0.05) during extension; 2) increased total joint motion of C0/C1 during first half range (P < 0.05) and decreased during second half range of extension, and total joint motion of C2/C3 increased during second half range of extension (P < 0.05) and; 3) increased pressure pain thresholds over left C2/C3 facet joint (P < 0.01). INTERPRETATION The cervical interspinous ligament pain redistributed anti-directional motion between C4/C5 and C2/C3 during dynamic extension and decreased pressure pain sensitivity over the left C2/C3 facet joint.
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Affiliation(s)
- Ning Qu
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Rene Lindstrøm
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Rogerio Pessoto Hirata
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark.
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Devaraja K. Approach to cervicogenic dizziness: a comprehensive review of its aetiopathology and management. Eur Arch Otorhinolaryngol 2018; 275:2421-2433. [PMID: 30094486 DOI: 10.1007/s00405-018-5088-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/06/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Though there is abundant literature on cervicogenic dizziness with at least half a dozen of review articles, the condition remains to be enigmatic for clinicians dealing with the dizzy patients. However, most of these studies have studied the cervicogenic dizziness in general without separating the constitute conditions. Since the aetiopathological mechanism of dizziness varies between these cervicogenic causes, one cannot rely on the universal conclusions of these studies unless the constitute conditions of cervicogenic dizziness are separated and contrasted against each other. METHODS This narrative review of recent literature revisits the pathophysiology and the management guidelines of various conditions causing the cervicogenic dizziness, with an objective to formulate a practical algorithm that could be of clinical utility. The structured discussion on each of the causes of the cervicogenic dizziness not only enhances the readers' understanding of the topic in depth but also enables further research by identifying the potential areas of interest and the missing links. RESULTS Certain peculiar features of each condition have been discussed with an emphasis on the recent experimental and clinical studies. A simple aetiopathological classification and a sensible management algorithm have been proposed by the author, to enable the identification of the most appropriate underlying cause for the cervicogenic dizziness in any given case. However, further clinical studies are required to validate this algorithm. CONCLUSIONS So far, no single clinical study, either epidemiological or interventional, has incorporated and isolated all the constitute conditions of cervicogenic dizziness. There is a need for such studies in the future to validate either the reliability of a clinical test or the efficacy of an intervention in cervicogenic dizziness.
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Affiliation(s)
- K Devaraja
- Department of Otorhinolaryngology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India.
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Malmström EM, Fransson PA, Jaxmar Bruinen T, Facic S, Tjernström F. Disturbed cervical proprioception affects perception of spatial orientation while in motion. Exp Brain Res 2017. [PMID: 28623390 PMCID: PMC5550524 DOI: 10.1007/s00221-017-4993-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The proprioceptive, visual and vestibular sensory systems interact to maintain dynamic stability during movement. The relative importance and interplay between these sensory systems is still not fully understood. Increased knowledge about spatial perception and postural orientation would provide better understanding of balance disorders, and their rehabilitation. Displacement of the body in space was recorded in 16 healthy subjects performing a sequence of stepping-in-place tests without any visual or auditory cues. Spatial displacement and orientation in space were determined by calculating two parameters, “Moved distance (sagittal + lateral displacement)” and “Rotation”. During the stepping-in-place tests vibration were applied in a randomized order on four different cervical muscles, and the effects were compared between muscles and to a non-vibration baseline condition. During the tests a forward displacement (“Moved distance”) was found to be the normal behavior, with various degrees of longitudinal rotation (“Rotation”). The moved distance was significantly larger when the vibration was applied on the dorsal muscles (916 mm) relative to on ventral muscles (715 mm) (p = 0.003) and the rate of displacement was significantly larger for dorsal muscles (36.5 mm/s) relative to ventral (28.7 mm/s) vs (p = 0.002). When vibration was applied on the left-sided muscles, 16° rotation to the right was induced (p = 0.005), whereas no significant rotation direction was induced with right-sided vibration (3°). The rate of rotation was significantly larger for vibration applied on ventral muscles (0.44°/s) relative to on dorsal (0.33°/s) (p = 0.019). The results highlight the influence of cervical proprioception on the internal spatial orientation, and subsequent for postural control.
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Affiliation(s)
- Eva-Maj Malmström
- Department of Pain Rehabilitation, Skåne University Hospital, Lund, Sweden. .,Department of Otorhinolaryngology, Clinical Sciences, Lund University, Lund, Sweden.
| | - Per-Anders Fransson
- Department of Otorhinolaryngology, Clinical Sciences, Lund University, Lund, Sweden
| | | | - Semir Facic
- Medpro Clinic Rehab AB, Torpavägen 23, Vänersborg, Sweden
| | - Fredrik Tjernström
- Department of Otorhinolaryngology, Clinical Sciences, Lund University, Lund, Sweden
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Sensorimotor Control in Individuals With Idiopathic Neck Pain and Healthy Individuals: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2017; 98:1257-1271. [DOI: 10.1016/j.apmr.2016.09.121] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/12/2016] [Accepted: 09/16/2016] [Indexed: 12/25/2022]
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Leung MY, Lo J, Leung YY. Accuracy of Different Modalities to Record Natural Head Position in 3 Dimensions: A Systematic Review. J Oral Maxillofac Surg 2016; 74:2261-2284. [PMID: 27235181 DOI: 10.1016/j.joms.2016.04.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/18/2016] [Accepted: 04/18/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Three-dimensional (3D) images are taken with positioning devices to ensure a patient's stability, which, however, place the patient's head into a random orientation. Reorientation of images to the natural head position (NHP) is necessary for appropriate assessment of dentofacial deformities before any surgical planning. The aim of this study was to review the literature systematically to identify and evaluate the various modalities available to record the NHP in 3 dimensions and to compare their accuracy. MATERIALS AND METHODS A systematic literature search of the PubMed, Cochrane Library and Embase databases, with no limitations on publication time or language, was performed in July 2015. The search and evaluations of articles were performed in 4 rounds. The methodologies, accuracies, advantages, and limitations of various modalities to record NHP were examined. RESULTS Eight articles were included in the final review. Six modalities to record NHP were identified, namely 1) stereophotogrammetry, 2) facial markings along laser lines, 3) clinical photographs and the pose from orthography and scaling with iterations (POSIT) algorithm, 4) digital orientation sensing, 5) handheld 3D camera measuring system, and 6) laser scanning. Digital orientation sensing had good accuracy, with mean angular differences from the reference within 1° (0.07 ± 0.49° and 0.12 ± 0.54°, respectively). Laser scanning was shown to be comparable to digital orientation sensing. The method involving clinical photographs and the POSIT algorithm was reported to have good accuracy, with mean angular differences for pitch, roll, and yaw within 1° (-0.17 ± 0.50°). Stereophotogrammetry was reported to have the highest reliability, with mean angular deviations in pitch, roll, and yaw for active and passive stereophotogrammetric devices within 0.1° (0.004771 ± 0.045645° and 0.007572 ± 0.079088°, respectively). CONCLUSIONS This systematic review showed that recording the NHP in 3 dimensions with a digital orientation sensor has good accuracy. Laser scanning was found to have comparable accuracy to digital orientation sensing, but routine clinical use was limited by its high cost and low portability. Stereophotogrammetry and the method using a single clinical photograph and the POSIT algorithm were potential alternatives. Nevertheless, clinical trials are needed to verify their applications in patients. Preferably, digital orientation sensor should be used as a reference for comparison with new proposed methods of recording the NHP in future research.
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Affiliation(s)
- Ming Yin Leung
- Resident, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - John Lo
- Honorary Associate Professor, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Yiu Yan Leung
- Clinical Assistant Professor, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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de Vries J, Ischebeck BK, Voogt LP, van der Geest JN, Janssen M, Frens MA, Kleinrensink GJ. Joint position sense error in people with neck pain: A systematic review. ACTA ACUST UNITED AC 2015; 20:736-44. [PMID: 25983238 DOI: 10.1016/j.math.2015.04.015] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 04/15/2015] [Accepted: 04/24/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND Several studies in recent decades have examined the relationship between proprioceptive deficits and neck pain. However, there is no uniform conclusion on the relationship between the two. Clinically, proprioception is evaluated using the Joint Position Sense Error (JPSE), which reflects a person's ability to accurately return his head to a predefined target after a cervical movement. OBJECTIVES We focused to differentiate between JPSE in people with neck pain compared to healthy controls. STUDY DESIGN Systematic review according to the PRISMA guidelines. METHOD Our data sources were Embase, Medline OvidSP, Web of Science, Cochrane Central, CINAHL and Pubmed Publisher. To be included, studies had to compare JPSE of the neck (O) in people with neck pain (P) with JPSE of the neck in healthy controls (C). RESULTS/FINDINGS Fourteen studies were included. Four studies reported that participants with traumatic neck pain had a significantly higher JPSE than healthy controls. Of the eight studies involving people with non-traumatic neck pain, four reported significant differences between the groups. The JPSE did not vary between neck-pain groups. CONCLUSIONS Current literature shows the JPSE to be a relevant measure when it is used correctly. All studies which calculated the JPSE over at least six trials showed a significantly increased JPSE in the neck pain group. This strongly suggests that 'number of repetitions' is a major element in correctly performing the JPSE test.
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Affiliation(s)
- J de Vries
- Department of Neuroscience, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Department of Physical Therapy, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, The Netherlands.
| | - B K Ischebeck
- Department of Neuroscience, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Spine and Joint Centre, Noordsingel 113, 3035 EM Rotterdam, The Netherlands.
| | - L P Voogt
- Department of Physical Therapy, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, The Netherlands.
| | - J N van der Geest
- Department of Neuroscience, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - M Janssen
- Department of Neuroscience, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - M A Frens
- Department of Neuroscience, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Erasmus University College, Rotterdam, P.O. Box 1738, 3000 BR Rotterdam, The Netherlands.
| | - G J Kleinrensink
- Department of Neuroscience-Anatomy, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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Pettorossi VE, Panichi R, Botti FM, Biscarini A, Filippi GM, Schieppati M. Long-lasting effects of neck muscle vibration and contraction on self-motion perception of vestibular origin. Clin Neurophysiol 2015; 126:1886-900. [PMID: 25812729 DOI: 10.1016/j.clinph.2015.02.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To show that neck proprioceptive input can induce long-term effects on vestibular-dependent self-motion perception. METHODS Motion perception was assessed by measuring the subject's error in tracking in the dark the remembered position of a fixed target during whole-body yaw asymmetric rotation of a supporting platform, consisting in a fast rightward half-cycle and a slow leftward half-cycle returning the subject to the initial position. Neck muscles were relaxed or voluntarily contracted, and/or vibrated. Whole-body rotation was administered during or at various intervals after the vibration train. The tracking position error (TPE) at the end of the platform rotation was measured during and after the muscle conditioning maneuvers. RESULTS Neck input produced immediate and sustained changes in the vestibular perceptual response to whole-body rotation. Vibration of the left sterno-cleido-mastoideus (SCM) or right splenius capitis (SC) or isometric neck muscle effort to rotate the head to the right enhanced the TPE by decreasing the perception of the slow rotation. The reverse effect was observed by activating the contralateral muscle. The effects persisted after the end of SCM conditioning, and slowly vanished within several hours, as tested by late asymmetric rotations. The aftereffect increased in amplitude and persistence by extending the duration of the vibration train (from 1 to 10min), augmenting the vibration frequency (from 5 to 100Hz) or contracting the vibrated muscle. Symmetric yaw rotation elicited a negligible TPE, upon which neck muscle vibrations were ineffective. CONCLUSIONS Neck proprioceptive input induces enduring changes in vestibular-dependent self-motion perception, conditional on the vestibular stimulus feature, and on the side and the characteristics of vibration and status of vibrated muscles. This shows that our perception of whole-body yaw-rotation is not only dependent on accurate vestibular information, but is modulated by proprioceptive information related to previously experienced position of head with respect to trunk. SIGNIFICANCE Tonic proprioceptive inflow, as might occur as a consequence of enduring or permanent head postures, can induce adaptive plastic changes in vestibular-dependent motion sensitiveness. These changes might be counteracted by vibration of selected neck muscles.
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Affiliation(s)
| | - Roberto Panichi
- Department of Experimental Medicine, University of Perugia, Italy
| | | | - Andrea Biscarini
- Department of Experimental Medicine, University of Perugia, Italy
| | | | - Marco Schieppati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy; Centro Studi Attività Motorie, Fondazione Salvatore Maugeri (IRCCS), Pavia, Italy.
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Abstract
The mechanisms by which the human brain controls eye movements are reasonably well understood, but those for the head less so. Here, we show that the mechanisms for keeping the head aimed at a stationary target follow strategies similar to those for holding the eyes steady on stationary targets. Specifically, we applied the neural integrator hypothesis that originally was developed for holding the eyes still in eccentric gaze positions to describe how the head is held still when turned toward an eccentric target. We found that normal humans make head movements consistent with the neural integrator hypothesis, except that additional sensory feedback is needed, from proprioceptors in the neck, to keep the head on target. We also show that the complicated patterns of head movements in patients with cervical dystonia can be predicted by deficits in a neural integrator for head motor control. These results support ideas originally developed from animal studies that suggest fundamental similarities between oculomotor and cephalomotor control, as well as a conceptual framework for cervical dystonia that departs considerably from current clinical views.
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Malmström EM, Eva-Maj M, Westergren H, Hans W, Fransson PA, Per-Anders F, Karlberg M, Mikael K, Magnusson M, Måns M. Experimentally induced deep cervical muscle pain distorts head on trunk orientation. Eur J Appl Physiol 2013; 113:2487-99. [PMID: 23812089 DOI: 10.1007/s00421-013-2683-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 06/14/2013] [Indexed: 01/01/2023]
Abstract
PURPOSE We wanted to explore the specific proprioceptive effect of cervical pain on sensorimotor control. Sensorimotor control comprises proprioceptive feedback, central integration and subsequent muscular response. Pain might be one cause of previously reported disturbances in joint kinematics, head on trunk orientation and postural control. However, the causal relationship between the impact of cervical pain on proprioception and thus on sensorimotor control has to be established. METHODS Eleven healthy subjects were examined in their ability to reproduce two different head on trunk targets, neutral head position (NHP) and 30° target position, with a 3D motion analyser before, directly after and 15 min after experimentally induced neck pain. Pain was induced by hypertonic saline infusion at C2/3 level in the splenius capitis muscle on one side (referred to as "injected side"). RESULTS All subjects experienced temporary pain and the head repositioning error increased significantly during head repositioning to the 30° target to the injected side (p = 0.011). A post hoc analysis showed that pain interfered with proprioception to the injected side during acute pain (p < 0.001), but also when the pain had waned (p = 0.002). Accuracy decreased immediately after pain induction for the 30° target position to the side where pain was induced (3.3 → 5.3°, p = 0.033), but not to the contralateral side (4.9 → 4.1°, p = 0.657). There was no significant impact of pain on accuracy for NHP. A sensory mismatch appeared in some subjects, who experienced dizziness. CONCLUSIONS Acute cervical pain distorts sensorimotor control with side-specific changes, but also has more complex effects that appear when pain has waned.
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Affiliation(s)
- Eva-Maj Malmström
- Unit for Specialized Pain Rehabilitation, Department of Rehabilitation Medicine, Skåne University Hospital, 221 85, Lund, Sweden,
| | - Malmström Eva-Maj
- Unit for Specialized Pain Rehabilitation, Department of Rehabilitation Medicine, Skåne University Hospital, 221 85, Lund, Sweden,
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The effect of neck torsion on joint position error in subjects with chronic neck pain. ACTA ACUST UNITED AC 2013; 18:562-7. [PMID: 23810427 DOI: 10.1016/j.math.2013.05.015] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/18/2013] [Accepted: 05/21/2013] [Indexed: 01/17/2023]
Abstract
The conventional cervical joint position error (JPE) test has been used as a measure of cervical afferent dysfunction in people with neck pain. However, head movement during the test may also stimulate the vestibular system. This study's objective is to investigate the effect of the modified JPE test with a neck torsion manoeuvre in order to determine if the new test is a more definitive measure of cervical afferent dysfunction. Twenty five volunteers with chronic neck pain and 26 healthy controls aged 18 to 60 were assessed on three tests of JPE: 'JPE conventional', 'JPE torsion' and 'Enbloc' (Control) using Fastrak and laser apparatus. The neck pain group was found to have significantly greater JPE in one conventional JPE test and almost all the torsion tests (p < 0.05). No differences in Enbloc(Control) tests were seen. Moderate to strong significant correlations were also seen between measures of JPE using the Fastrak and laser methodology (p ≤ 0.01). The results of this preliminary study indicate that 'JPE torsion' may be a more suitable test than 'JPE conventional' for cervical afferent dysfunction in people with chronic neck pain although future comparisons with people suffering from vestibulopathy is warranted to support these findings. Additionally, the laser method is comparable to Fastrak and may be useful as a clinical measure of repositioning errors for both conventional and torsion tests.
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Current Opinion in Otolaryngology & Head and Neck Surgery. Current world literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:466-74. [PMID: 20827086 DOI: 10.1097/moo.0b013e32833f3865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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