Proprioception of the neck is easily assessed in the clinic using a laser attached to the head.
The subject performs a physiological movement such as left cervical rotation with their eyes closed and attempts to return to the starting position – the neutral head position.
There will be a difference (99% of the time!) between their starting point and the return point. This difference can be measured in centimetres to describe the joint position error.
The methodology is here and the target here. Note the inner and outer broken circles of the target refer to the average values for normal (inner circles) pain free subjects and neck pain (outer circles) subjects, respectively. These values are taken from Stanton et al’s systematic review (2016).
Measure subject sitting 100 cm from tip of laser to wall.
- Eyes closed they perform cervical rotation and flex / ext (slowly so as not to stimulate vestibular system)
- Then they return to neutral head position eyes still closed.
- THEN you stick target to wall with ‘post-its’ or masking tape – thus target is centred to THEIR neutral head position.
- NOW instruct the subject to open their eyes: say ‘remember this position, in a moment you will close your eyes and move your head to the left as far as is comfortable and try and return to this point, when you think you are back at the centre of the target say STOP and do not open your eyes.’
- At the point they say ‘STOP’ mark on the chart where the laser is.
- The subject KEEPS THEIR EYES CLOSED. You passively return their head to the neutral head position established in 3. above and repeat a total of three measurements in each direction, taking the average.
Stanton TR (2016) Evidence of Impaired Proprioception in Chronic, Idiopathic Neck Pain: Systematic Review and Meta-Analysis.; Phys Ther 96 (6):876-87