Head eye co-ordination and gaze stability in subjects with persistent whiplash associated disorders.

Symptoms of dizziness, unsteadiness and visual disturbances are frequent complaints in persons with persistent whiplash associated disorders. This study investigated eye, head co-ordination and gaze stability in subjects with persistent whiplash (n = 20) and asymptomatic controls (n = 20). Wireless motion sensors and electro-oculography were used to measure: head rotation during unconstrained head movement, head rotation during gaze stability and sequential head and eye movements. Ten control subjects participated in a repeatability study (two occasions one week apart). Between-day repeatability was acceptable (ICC > 0.6) for most measures. The whiplash group had significantly less maximal eye angle to the left, range of head movement during the gaze stability task and decreased velocity of head movement in head eye co-ordination and gaze stability tasks compared to the control group (p < 0.01). There were significant correlations (r > 0.55) between both unrestrained neck movement and neck pain and head movement and velocity in the whiplash group. Deficits in gaze stability and head eye co-ordination may be related to disturbed reflex activity associated with decreased head range of motion and/or neck pain. Further research is required to explore the mechanisms behind these deficits, the nature of changes over time and the tests' ability to measure change in response to rehabilitation.

[1]  A. Håkansson,et al.  Dizziness among patients with whiplash-associated disorder: a randomized controlled trial. , 2006, Journal of rehabilitation medicine.

[2]  J. Fleiss.  The design and analysis of clinical experiments , 1987 .

[3]  F. Honegger,et al.  Trunk Sway Measures of Postural Stability During Clinical Balance Tests in Patients With Chronic Whiplash Injury Symptoms , 2003, Spine.

[4]  Etienne Olivier,et al.  Neck muscle responses to stimulation of monkey superior colliculus. I. Topography and manipulation of stimulation parameters. , 2002, Journal of neurophysiology.

[5]  L. Tesio,et al.  Short form of the Dizziness Handicap Inventory: construction and validation through Rasch analysis. , 1999, American journal of physical medicine & rehabilitation.

[6]  Julia Treleaven,et al.  Retraining cervical joint position sense: The effect of two exercise regimes , 2007, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  C. D. De Zeeuw,et al.  The cervico-ocular reflex is increased in whiplash injury patients. , 2005, Journal of neurotrauma.

[8]  B W Peterson,et al.  Cervicocollic reflex: its dynamic properties and interaction with vestibular reflexes. , 1985, Journal of neurophysiology.

[9]  J. Hoffman,et al.  American Journal of Physical Medicine and Rehabilitation , 2007 .

[10]  M. Revel,et al.  Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. , 1994, Archives of physical medicine and rehabilitation.

[11]  Brian D Corneil,et al.  Countermanding eye-head gaze shifts in humans: marching orders are delivered to the head first. , 2005, Journal of neurophysiology.

[12]  B. Peterson.  Current approaches and future directions to understanding control of head movement. , 2004, Progress in brain research.

[13]  Thomas Rosemeier,et al.  Interaction of vestibular, somatosensory and visual signals for postural control and motion perception under terrestrial and microgravity conditions—a conceptual model , 1998, Brain Research Reviews.

[14]  S. Jaric,et al.  Vertical posture and head stability in patients with chronic neck pain. , 2003, Journal of rehabilitation medicine.

[15]  C. Claussen,et al.  Neurootological contributions to the diagnostic follow-up after whiplash injuries. , 1995, Acta oto-laryngologica. Supplementum.

[16]  Julia Treleaven,et al.  Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error. , 2003, Journal of rehabilitation medicine.

[17]  Barbara Cagnie,et al.  Reliability and normative database of the Zebris cervical range-of-motion system in healthy controls with preliminary validation in a group of patients with neck pain. , 2007, Journal of manipulative and physiological therapeutics.

[18]  B. K. Humphreys,et al.  The Effect of a Rehabilitation Exercise Program on Head Repositioning Accuracy and Reported Levels of Pain in Chronic Neck Pain Subjects , 2002 .

[19]  C. Joyce,et al.  Tracking eye fixations with electroocular and electroencephalographic recordings. , 2002, Psychophysiology.

[20]  H. Slijper,et al.  Adaptation of the cervico- and vestibulo-ocular reflex in whiplash injury patients. , 2008, Journal of neurotrauma.

[21]  G. Jull,et al.  Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. , 2005, Journal of rehabilitation medicine.

[22]  C. Newman,et al.  Balance function test correlates of the Dizziness Handicap Inventory. , 1991, Journal of the American Academy of Audiology.

[23]  G. Holstege,et al.  The emotional brain: neural correlates of cat sexual behavior and human male ejaculation. , 2004, Progress in brain research.

[24]  S. Mior,et al.  The Neck Disability Index: a study of reliability and validity. , 1991, Journal of manipulative and physiological therapeutics.

[25]  G. Jull,et al.  Are cervical physical outcome measures influenced by the presence of symptomatology? , 2002, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[26]  C. Tjell,et al.  Disturbed eye movements after whiplash due to injuries to the posture control system. , 1996, Journal of clinical and experimental neuropsychology.

[27]  Scott Haldeman,et al.  Treatment of Neck Pain: Noninvasive Interventions: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders , 2008, Spine.

[28]  G. Jull,et al.  Cervical Range of Motion Discriminates Between Asymptomatic Persons and Those With Whiplash , 2001, Spine.

[29]  G. Jull,et al.  Standing balance in persistent whiplash: a comparison between subjects with and without dizziness. , 2005, Journal of rehabilitation medicine.

[30]  R Gimse,et al.  Driving skills after whiplash. , 1997, Scandinavian journal of psychology.

[31]  A W NORTH,et al.  ACCURACY AND PRECISION OF ELECTRO-OCULOGRAPHIC RECORDING. , 1965, Investigative ophthalmology.

[32]  T. Mergner,et al.  Eye movements evoked by proprioceptive stimulation along the body axis in humans , 1998, Experimental Brain Research.

[33]  J. Goebel,et al.  Postural stability following mild head or whiplash injuries. , 1995, The American journal of otology.

[34]  G. Jull,et al.  A study of five cervicocephalic relocation tests in three different subject groups , 2003, Clinical rehabilitation.

[35]  Fredrik Öhberg,et al.  Chronic whiplash associated disorders and neck movement measurements: an instantaneous helical axis approach , 2003, IEEE Transactions on Information Technology in Biomedicine.

[36]  U. Rosenhall,et al.  Smooth pursuit neck torsion test: a specific test for cervical dizziness. , 1998, The American journal of otology.

[37]  Julia Treleaven,et al.  Head Eye Co-ordination Using Simultaneous Measurement of Eye in Head and Head in Space Movements: Potential For Use in Subjects With a Whiplash Injury , 2009, Journal of Clinical Monitoring and Computing.

[38]  S. Jaric,et al.  Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity. , 2008, Manual therapy.

[39]  T. Mergner,et al.  Interaction between cervico-ocular and vestibulo-ocular reflexes in normal adults , 2004, Experimental Brain Research.

[40]  P. Diakow,et al.  Effect of neck pain on verticality perception: a cohort study. , 2002, Archives of physical medicine and rehabilitation.

[41]  Julia Treleaven,et al.  Dynamic and functional balance tasks in subjects with persistent whiplash: a pilot trial. , 2011, Manual therapy.

[42]  S. Sangiorgi,et al.  Whiplash injury and oculomotor dysfunctions: clinical–posturographic correlations , 2006, European Spine Journal.

[43]  Ball catching in children with developmental coordination disorder: control of degrees of freedom , 2006, Developmental medicine and child neurology.