Index to Chiropractic Literature
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ID 19340
  Title Evaluation of proprioception in the cervical spine using an electromagnetic tracking system [Presented at the 1st College of Chiropractors’ Research Conference, 16th June 2006, BMA House, London, UK]
URL http://tinyurl.com/yhnwgf
Journal Clin Chiropr. 2006 Dec;9(4):195
Author(s)
Subject(s)
Peer Review Yes
Publication Type Meeting Abstract
Abstract/Notes Background: There is a high level of chronicity and recurrence of symptoms amongst neck pain patients. Understanding of the specific physical function effects of neck pain could provide a target for therapeutic interventions, such as rehabilitation. Under normal conditions, information from proprioceptors in joints and muscles of the cervical spine contribute to perception of spatial orientation of head and eye position in relation to the body and the external world, enabling us to stabilise head position and accurately control gaze. This suggests that neck dysfunction may be associated with impaired eye movements and cervicocephalic kinaesthesia during movement, Two studies are planned, the first aims to investigate these effects in different sub-groups of neck pain patients; this will be followed by a randomised controlled trial with chiropractic manipulation. A pilot study was carried out to evaluate the outcome measures to be used in these studies. The results for the measures of proprioception are presented here.

Aims: The pilot study aimed to ascertain the intraexaminer reliability of measures of eye and head sensorimotor control, and the feasibility of implementing these. A further aim was to compare performance in two different tests proposed as measures of proprioception and kinaesthesia, in order to examine their construct validity.

Study design: An intra-examiner, test/re-test design was used.

Methods: The performance of fourteen asymptomatic subjects was measured in a range of tasks, including two tests of proprioceptive or kinaesthetic function. A polhemus Fastrak electromagnetic tracking system was used to record head position and motion in a head repositioning task and in a task where subjects moved their head in order to track a moving visual target. All measures were repeated twice on day 1 and once on day 5—7, enabling within day and between day performance to be compared.

Results: Substantial to high levels of reliability (intraclass correlation (ICC) 2, k values 0.62—0.919) were indicated for all proprioception/kinaesthesia tasks. Some learning effect across the three test occasions was indicated for individual subjects in some tasks, although for the group ANOVA only reached ignificance in head repositioning following an extension movement (F = 5.37, P = 0.01). Correlation between individual subjects’ performance in the head repositioning and head tracking tasks was low (Pearson’s r = 0.011—0.458).

Conclusions: Good reliability of the outcome measures was shown; however, the possibility of some learning effect suggested by the ANOVA highlights the importance of considering this alongside the ICC. Minor odifications to the training and test schedule for head repositioning and head tracking tasks will be made for subsequent studies using neck pain patients. The feasibility of using these outcome measures was established. The low level of correlation of performance in the head repositioning and head tracking tasks raises questions over the validity of either or both tsks as measures of underlying proprioceptive function and further investigation is needed. However, this does not invalidate their use as combined measures of sensorimotor control of the head and neck. Two tests measuring different aspects may be useful in investigating differences between sub-categories of neck pain patient.

This abstract is reproduced with the permission of the publisher.


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