Objective
Assessment of recovery following vestibular loss has been limited by the lack of bedside measures in clinical settings. Here, we used the video ocular counter‐roll (vOCR) test to study ...otolith‐ocular function and compensatory effect of neck proprioception in patients at different stages of vestibular loss.
Study Design
Case‐control study.
Setting
Tertiary care center.
Methods
Fifty‐six subjects were recruited including patients with acute (9 ± 2 days mean ± standard error of mean), subacute (61 ± 11 days), and chronic (1009 ± 266 days) unilateral loss of vestibular function, as well as a group of healthy controls. We used a video‐oculography method based on tracking the iris for vOCR measurement. To examine the effect of neck inputs, vOCR was recorded during two simple tilt maneuvers in all subjects while seated: 30° head‐on‐body tilt and 30° head‐and‐body tilt.
Results
The vOCR responses evolved at different stages following vestibular loss with improvement of the gains in the chronic stage. The deficit was more pronounced when the whole body was tilted (acute: 0.08 ± 0.01, subacute: 0.11 ± 0.01, chronic: 0.13 ± 0.02, healthy control: 0.18 ± 0.01), and the gain of vOCR improved when the head was tilted on the body (acute: 0.11 ± 0.01, subacute: 0.14 ± 0.01, chronic: 0.13 ± 0.02, healthy control: 0.17 ± 0.01). The time course of vOCR response was affected as well with reduced amplitude and slower response in the acute stage of vestibular loss.
Conclusion
The vOCR test can be valuable as a clinical marker to measure vestibular recovery and compensatory effect of neck proprioception in patients at different stages following loss of vestibular function.
Purpose: Neck pain is a prevalent musculoskeletal issue among bike drivers, often resulting from extended static postures, repetitive head movements, and exposure to vibrations. This study aims to ...assess the connection between cervical ROM, neck proprioception, CVA, and QOL in bike drivers with neck pain compared to those without neck pain so that the targeted interventions can be developed to enhance their well-being. Methods: A cross-sectional study involving 100 bike drivers aged 20-50 years was conducted, split into two groups: those with neck pain (n=50) and those without neck pain (n=50). Cervical ROM was measured using a smartphone, neck proprioception was assessed through a head repositioning test, and CVA was determined using lateral-view photographs with a plumb line. The Short Form-36 (SF-36) questionnaire was employed to evaluate QOL. Data analysis was conducted using independent t-tests and Pearson's correlation coefficient. Results: Bike drivers with neck pain exhibited significantly reduced cervical ROM (p-value=<0.001), impaired neck proprioception (p-value=<0.001), and decreased CVA (p-value=<0.001) compared to their counterparts without neck pain. A strong negative correlation was found between neck pain and QOL, with lower scores in all eight domains of the SF-36. Cervical ROM, neck proprioception, and CVA showed moderate correlations with various QOL domains (p-value=<0.05). Conclusion: Neck pain in bike drivers is linked to decrease cervical ROM, compromised neck proprioception, and reduced CVA. These factors correlate with a lower quality of life, both physical and mental domains. Interventions addressing these aspects may enhance the quality of life for bike drivers experiencing neck pain. Keywords: cervical range of motion, neck proprioception, craniovertebral angle, quality of life, neck pain, bike drivers
In upright standing, the human foot sole is the only point of contact with the ground conveying information about the pressure distribution under the feet. We examined how the altered somatosensory ...input from the plantar foot receptors, when standing on a soft surface, affects the subjective estimation of the earth vertical in different sensory contexts.
Twelve (12) healthy young females (mean age: 21.8 ± 2.4 years) adjusted the orientation of a visual line (35 × 1.5 cm) representing the roll orientation of a hand-held (attached on a 24.9 × 4 cm cylinder) or head-attached electromagnetic tracking sensor (Nest of Birds, Ascension Technologies Inc., VT. USA, 60 Hz) under two visual conditions (eyes open, eyes closed) while standing on a soft or firm surface. The mean absolute (accuracy) and variable (precision) error in the verticality estimate was depicted in the sensor's roll deviation from the gravitational vertical.
The accuracy and the precision of the estimate decreased in the absence of vision, while standing on the soft surface and when the estimate was provided by an active hand rather than head rotation. The surface effect was significant only in the absence of vision and when the estimate was provided by the hand.
The contribution of the plantar foot mechanoreceptors to gravity perception is sensory context dependent. Perception of the earth vertical is more accurate when estimated by active head rotation due to the integration of the vestibular and neck proprioceptive afferents.
To assess the utility of the paraclinical tests in patients presenting with clinical diagnosis of cervicogenic dizziness.
Case controlled.
Otolaryngology clinic of a tertiary referral hospital ...center.
Twenty-five subjects with cervicogenic dizziness and 25 subjects with benign paroxysmal positional vertigo.
Symptoms description, Dizziness Handicap Inventory-short form (DHI), Trait anxiety score, cervical joint position error, the smooth pursuit neck torsion and cervical torsion tests on videonystagmography, and standing balance test (timed 10-meter walk with head turns).
The results showed differences in reported symptoms, in mean cervical joint position error (p = 0.001), and cervical torsion test (p = 0.001) between the two groups. There was no between-group difference for DHI scores (p = 0.137), trait anxiety scores (p = 0.240), and walking test: time (p = 0.797), steps (p = 0.963). The Youden index is 0.60 for the predictive value of the cervical joint position error, and the smooth pursuit and the cervical torsion tests.
This study showed differences in sensorimotor disturbances between the two groups, particularly in the control of head and eye movements and cervical proprioception. Patients with cervicogenic dizziness were more likely to (1) have a sensation of drunkenness and lightheadedness, (2) have pain induced during the physical examination of the upper cervical vertebrae, (3) have an elevated joint position error of 4.5 degrees during the cervical relocation test, and (4) exhibit more than 2 degrees per second nystagmus during the cervical rotation test. The walking test was not able to differentiate the two groups.
Highlights • Asymmetric whole-body back-and-forth yaw rotation induces a bias in vestibular self-motion perception. • The perceptive bias is modulated by unilateral neck muscle vibration, depending ...on the function of the vibrated neck muscle. • The bias in the modulation can persist several hours depending on frequency and duration of the vibration train.
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 (JPE
) 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
< 0.05, for JPE
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.
Evaluation of cervical joint position sense in subjects with chronic neck pain has gained importance in recent times. Different authors have established increased joint position error (JPE) in ...subjects with acute neck pain. However, there is a paucity of studies to establish the influence of chronic neck pain on cervical JPE.
The objective of the study was to understand the influence of chronic neck pain on cervical JPE, and to examine the differences in cervical JPE between young and elderly subjects with chronic neck pain.
Forty-two chronic neck pain patients (mean age 47.4) were compared for cervical JPE with 42 age-matched healthy subjects (mean age 47.8), using a digital inclinometer. The cervical JPE were measured in flexion, extension, and rotation in right and left movement directions.
The comparison of JPE showed significantly larger errors in subjects with chronic neck pain when compared to healthy subjects (p< 0.001). The errors were larger in all of the movement directions tested. Comparison between young and older subjects with chronic neck pain revealed no significant differences (P> 0.05) in cervical JPE.
Cervical joint position sense is impaired in subjects with chronic neck pain.
Whilst the importance of trunk, lower and upper extremities for the efficiency of maintaining body sway is well documented, the effects of cervical spine function have been seldom investigated. ...Afferent information from high density proprioceptors located in the cervical spine can alter postural balance, however the effects of sport’s specific habitual adaptation on balance performance have not yet been investigated. Twenty-seven taekwondo fighters and thirty controls performed unilateral balance tasks while facing forward and during neck torsion balance test while standing on the force plate. Neck kinesthesia was measured with the Head-to-Neutral Relocation test and the Butterfly test with motion-inertial unit. Differences between balance tasks were analyzed using two-way ANOVA. Additionally, correlations between body sway parameters and neck kinesthesia were studied using Pearson correlation coefficient. No differences were found between forward facing and neck torsion balance tasks in taekwondo fighters. However, correlations were found between balance on the non-preferred leg and neck kinesthesia. On the contrary, healthy individuals presented with statistically significant differences between both balance tasks and correlations between balance and neck kinesthesia. Taekwondo fighters seem to present with habitual adaptations in balance control, that differ from non-trained individuals.
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