Sensorimotor disturbances in people with non-specific neck pain

Abstract

This thesis aimed to describe the interactions between head and eye movement systems in people with neck pain. The first paper (_chapter 2_) of this thesis was a systematic review in which we described joint position sense error (JPSE) in people with neck pain. In general, it can be concluded that people with neck pain show a larger cervical JPSE error when it is measured over at least six trials. There was no difference between onset, pain intensity, or duration regarding the joint position sense error. The paper concerning the cervico-ocular reflex (COR) in people with non-specific neck pain (_chapter 3_) showed an altered gain of the COR in non-specific neck pain in comparison to people without neck pain. The VOR did not differ between these two groups. The COR differed on a group level, and there was no correlation between cervical range of motion, pain intensity, dizziness, and the gain of the COR. This was the first study describing the COR in a study population of people with non-specific neck pain, which is by far the majority of people with neck pain. _Chapter 4_ was a letter to the editor on ‘the cervico-ocular reflex is increased in people with non-specific neck pain.’ In _chapter 5_ we described the relationship between the COR and the JPSE. Here we presented a correlation between the COR and the JPSE in a vertical plane. As both tests receive information from the cervical spine, this was expected. What was less expected was the result that there was no correlation between the COR and the JPSE in the horizontal because the COR was measured in a horizontal plane and not in a vertical plane. The fact that the JPSE is a representation of different aspects of sensorimotor function can explain this finding. In _chapters 6 and 7_, we described the effect of static neck torsion and target predictability on smooth pursuit eye movements and saccadic eye movements in people without neck pain and people with neck pain. The Smooth Pursuit Neck Torsion test is used as a clinical measure for oculomotor disorders in people with neck pain. However, it is doubtful that the SPNT merely tests the influence of cervical proprioception on smo