A study of five cervicocephalic relocation tests in three different subject groups

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Abstract
Objective: To compare head relocation accuracy in traumatic (whiplash), insidious onset neck pain patients and asymptomatic subjects when targeting a natural head posture (NHP) and complex predetermined positions. Design: A case–control study. Setting: University-based musculoskeletal research clinic. Participants: Sixty-three volunteers divided into three groups of similar gender and age: Group 1 ( n = 21) an asymptomatic group; group 2 ( n = 20) insidious onset neck pain; group 3 ( n = 22) a history of whiplash injury. Intervention: Five randomly ordered tests designed to detect relocation accuracy of the head. Outcome measures: A 3-Space Fastrak system measured the mean absolute relocation error of three trials of each relocation test. Results: A significant difference was found between groups in one of the tests targeting the NHP ( p = 0.001). Post-hoc pairwise comparisons revealed a significant difference ( p £ 0.05) between the asymptomatic group and each symptomatic group. The difference between the symptomatic groups just failed to reach significance ( p = 0.07). None of the other four tests revealed significant differences. Conclusion: The test of targeting the NHP indicates that relocation inaccuracy exists in patients with neck pain with a trend to suggest that the deficit may be greater in whiplash patients. Tests employing unfamiliar postures or more complex movement were not successful in differentiating subject groups.