Treleaven J, LowChoy N, Darnell R, Panizza B, Brown-Rothwell D, Jull G. Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma.
To determine if differences exist in reported symptoms and in outcomes of sensorimotor tests (cervical joint position error [JPE], neck-influenced eye movement control, postural stability) between subjects with persistent whiplash and subjects with unilateral vestibular pathology associated with acoustic neuroma.
Repeated measures, case controlled.
Tertiary institution and metropolitan hospital.
Twenty subjects with persistent whiplash, 20 subjects with acoustic neuroma, and 20 control subjects.
Main Outcome Measures
Symptom descriptors, Dizziness Handicap Inventory (short form), measures of cervical JPE, the smooth pursuit neck torsion (SPNT) test, and forceplate measures of postural stability in comfortable and narrow stances.
The results showed differences in SPNT (P=.00), selected measures of postural stability (P<.04), and reported symptoms between the whiplash and vestibular groups. There was no between-group difference in cervical JPE (P>.27) or dizziness handicap (P>.69).
This study showed differences in sensorimotor disturbances between subjects with discreet whiplash and those with vestibular pathology associated with acoustic neuroma. The results support the SPNT test as a test of cervical afferent dysfunction. Further research into cervical JPE as a discreet test of cervical afferentation is warranted.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Archives of Physical Medicine and Rehabilitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error.J Rehabil Med. 2003; 35: 36-43
- Cervicocephalic kinesthetic sensibility in patients with whiplash injury.Scand J Rehabil Med. 1996; 28: 133-138
- Smooth pursuit neck torsion test: a specific test for cervical dizziness.Am J Otol. 1998; 19: 76-81
- Smooth pursuit neck torsion test in whiplash associated disorders: relationship to self reports of neck pain and disability, dizziness and anxiety.J Rehabil Med. 2005; 37: 219-223
- Balance control near the limit of stability in various sensory conditions in healthy subjects and patients suffering from vertigo or balance disorders: impact of sensory input on balance control.Acta Otolaryngol. 2000; 120: 508-516
- Postural stability following mild head or whiplash injuries.Am J Otol. 1995; 16: 216-221
- Quantitative posturography in altered sensory conditions: a way to assess balance instability in patients with chronic whiplash injury.Arch Phys Med Rehabil. 2004; 85: 432-438
- Vertical posture and head stability in patients with chronic neck.J Rehabil Med. 2003; 35: 229-235
- Trunk sway measures of postural stability during clinical balance tests in patients with chronic whiplash injury symptoms.Spine. 2003; 28: 1725-1734
- Standing balance in persistent whiplash: comparison between subjects with and without dizziness.J Rehabil Med. 2005; 37: 224-229
- Encoding target-trunk relative position: cervical versus vestibular contribution.Exp Brain Res. 1998; 122: 101-107
- Illusions of head and visual target displacement induced by vibration of neck muscles.Brain. 1991; 114: 755-759
- Proprioception in the neck.Exp Brain Res. 1988; 70: 351-360
- Eye movements evoked by proprioceptive stimulation along the body axis in humans.Exp Brain Res. 1998; 120: 450-460
- Balance, mobility and gaze deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): an observational study.Aust J Physiother. 2006; 52: 211-216
- Postural strategies associated with somatosensory and vestibular loss.Exp Brain Res. 1990; 82: 167-177
- Is the method of signal analysis and test selection important for measuring standing balance in chronic whiplash?.Gait Posture. 2005; 21: 395-402
- Postural responses to vibration of neck muscles in patients with uni- and bilateral vestibular loss.Gait Posture. 1998; 7: 228-236
- Dynamic posture assessment in patients with peripheral vestibulopathy.Acta Otolaryngol (Stockh). 2004; 124: 700-705
- Dynamic posturography (EquiTest): outcome after vestibular neurotomy or acoustic neuroma removal.Oto-Rhino-Laryngologia Nova. 1998; 8: 290-296
- Scientific monograph of Quebec Task Force on Whiplash Associated Disorders: redefining “whiplash” and its management [published erratum in: Spine 1995;20:2372].Spine. 1995; 20: 1S-73S
- Short form of the dizziness handicap inventory.Am J Phys Med Rehabil. 1999; 78: 233-241
- The development of a six item short-form of the Spielberger State Trait Anxiety Inventory (STAI).Br J Clin Psychol. 1992; 3: 301-306
- Cervicocephalic kinesthetic sensibility in patients with cervical pain.Arch Phys Med Rehabil. 1991; 72: 288-291
- Quantification of tracking eye movements in normal subjects.Acta Otolaryngol. 1980; 90: 404-413
- Assessing the influence of sensory integration on balance.Phys Ther. 1986; 66: 1548-1550
- Preferred foot placement during quiet stance: development of a standardized foot placement for balance testing.Clin Biomech (Bristol, Avon). 1997; 12: 66-70
- Trunk sway measures of postural stability during clinical balance tests: effects of a unilateral vestibular deficit.Gait Posture. 2001; 14: 227-237
- Head movement restriction and postural stability in patients with compensated unilateral vestibular loss.Arch Phys Med Rehabil. 1998; 79: 1448-1450
- Cervicocephalic kinaesthesia: reliability of a new test approach.Physiother Res Int. 2001; 6: 224-235
- Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine.Clin Chem. 1993; 39: 561-567
- Dynamic posturography in the diagnosis and management of dizziness and balance disorders.Neurol Clin. 1990; 8: 331-349
- Differential diagnosis of proprioceptive and vestibular deficits using dynamic support-surface posturography.Gait Posture. 2001; 14: 217-226
- Neck muscle vibration disrupts steering of locomotion.J Appl Physiol. 2001; 91: 581-588
- Neck proprioceptive inputs to primate vestibular nucleus neurons.Exp Brain Res. 2000; 135: 511-526
- The perception of body orientation after neck-proprioceptive stimulation.Exp Brain Res. 2002; 143: 350-358
- Perceptual and oculomotor effects of neck muscle vibration in vestibular neuritis.Brain. 1998; 121: 677-685
- Vibration-induced shift of the subjective visual horizontal: a sign of unilateral vestibular deficit.Arch Otolaryngol Head Neck Surg. 2002; 128: 21-27
- Neck vibration: usefulness in neurotology.Rev Neurol. 2004; 38: 1061-1066
- A new clinical test for cervicocephalic kinesthetic sensibility: “the fly”.Arch Phys Med Rehabil. 2004; 85: 490-495
- A study of five cervicocephalic relocation tests in three different subject groups.Clin Rehabil. 2003; 17: 768-774
- Cervicocephalic kinesthetic sensibility, active range of cervical motion, and oculomotor function in patients with whiplash injury.Arch Phys Med Rehabil. 1998; 79: 1089-1094
- Effects of acupuncture, cervical manipulation and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study.Man Ther. 2000; 5: 151-157
- Retraining cervical joint position sense: the effect of two exercise regimes.J Orthop Res. 2007; 25: 404-412
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
© 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.