Inter-Visit Reliability of Smooth Pursuit Neck Torsion Test in Patients with Chronic Neck Pain and Healthy Individuals

Visual disturbances are commonly reported in patients with neck pain. Smooth pursuit neck torsion (SPNT) test performed in neutral position and with trunk rotated under the stationary head has been used to discriminate between those with cervical component and those without. However, no studies investigated the reliability of the SPNT-test in patients with chronic neck pain and healthy controls. The aim of this study was to assess inter-visit reliability of the SPNT-test while applying different amplitudes and velocities of target movement. Thirty-two controls and thirty-one patients were enrolled in the study. The SPNT-test was performed in neutral position and through 45° torsion positions. The test was performed at 20°/s, 30°/s and 40°/s velocities and at 30°, 40° and 50° amplitudes of cyclic sinusoidal target movements. Interclass correlation coefficient and smallest detectable change were calculated for parameters of gain and SPNT-differences. In patients, moderate to good reliability was observed for gain at 40° and 50° amplitudes and for 20°/s and 30°/s velocities, while moderate to excellent reliability for gain was observed in controls. Both groups presented with moderate to good reliability for SPNT-difference. Our findings imply that amplitudes of 40° and 50° and velocities of 20°/s and 30°/s are the most reliable and should be applied in future studies assessing oculomotor functions during the SPNT test.

Sport-Specific Habitual Adaptations in Neck Kinesthetic Functions Are Related to Balance Controlling Mechanisms

Whilst the importance of trunk, lower and upper extremities for the efficiency of maintaining body sway is well documented, the effects of cervical spine function have been seldom investigated. Afferent information from high density proprioceptors located in the cervical spine can alter postural balance, however the effects of sport’s specific habitual adaptation on balance performance have not yet been investigated. Twenty-seven taekwondo fighters and thirty controls performed unilateral balance tasks while facing forward and during neck torsion balance test while standing on the force plate. Neck kinesthesia was measured with the Head-to-Neutral Relocation test and the Butterfly test with motion-inertial unit. Differences between balance tasks were analyzed using two-way ANOVA. Additionally, correlations between body sway parameters and neck kinesthesia were studied using Pearson correlation coefficient. No differences were found between forward facing and neck torsion balance tasks in taekwondo fighters. However, correlations were found between balance on the non-preferred leg and neck kinesthesia. On the contrary, healthy individuals presented with statistically significant differences between both balance tasks and correlations between balance and neck kinesthesia. Taekwondo fighters seem to present with habitual adaptations in balance control, that differ from non-trained individuals.

Three-Dimensional Morphological Analysis of the Femoral Neck Torsion Angle - An Anatomical Study

Background: The femoral neck torsion angle (FNTA) is an important but often neglected parameter in assessments of the anatomical morphology of the femoral neck, which is often confused with the femoral neck anteversion angle (FNAA) in the current literature. Currently, the measurement methods reported in the literature all adopt the naked eye or two-dimensional (2D) visualization method, and the measurement parameters and details are not clearly defined. The objection of this research was to provide a reliable 3D method for determining the femoral neck axis, to improve the measurement method of the FNTA, and to analyze the anatomical and clinical significance of the results.Methods: Computed tomography (CT) data of 200 patients who received a lower extremity CT angiography examination were selected, and the bilateral femurs were reconstructed with three dimensional CT (3D CT). First, the 3D axis of the femoral neck was built. Second, the long axis of the cross section the femoral neck isthmus (FNI) and femoral neck basilar part (FNB) were confirmed by the “inertia axes” method, and the plane consisting of the long axis of the cross-section and the center of the femoral head was defined as the long axial plane. Third, the coronal plane of the proximal femur was determined through the long axis of the proximal femur and the femoral coronal. Finally, the FNTAs (the angles between the long axial planes and the coronal plane of the proximal femur) of FNI and FNB were measured. The size of FNTA was compared between the sexes and sides and different locations, the correlation between the parameters and age, height and weight were evaluated.Results: The difference in FNTA was statistically significant between the isthmus and the basilar part (isthmus 30.58 ± 8.90° vs. basilar part 23.79 ± 3.98°; p < 0.01). Significant difference in the FNTA was observed between the sexes (males 31.99 ± 9.25° vs. females 27.49 ± 7.19°; p < 0.01). The increase in FNTA from the basilar part to the isthmus was 6.79 ± 8.06°, and the male (7.87 ± 8.57°) was greater than the female (4.44 ± 6.23°, p < 0.01). However, no significant difference in the values was observed between sides. Height exerted the greatest effect on the FNTA according to the correlation analysis (r = 0.255, p＜0.001). Conclusions: This study found a reliable 3D method for the determination of the femoral neck axis improved the measurement method of the FNTA and made it more accurate and repeatable. The results provided a methodological basis and theoretical support for the research and development of internal fixation device for femoral neck fracture and the spatial configuration of implants in treatment. And, the optimal opening point of the femoral medullary cavity was recommended to locate at the posterior position of the top of the femoral neck cross-section during hip replacement.

Three-Dimensional Morphological Analysis of the Femoral Neck Torsion Angle - An Anatomical Study.

Background: The femoral neck torsion angle (FNTA) is a very important but often neglected parameter in assessments of the anatomical morphology of the femoral neck, and it is often confused with the femoral neck anteversion angle (FNAA) in the current literature. Currently, naked eye or two-dimensional literature (2D) visualization method was used in the literature that the measurement method reported, and the measurement parameters and details are not clearly defined. The objection of this research was to establish a three-dimensional (3D) method to measure the FNTA, and to analyse the anatomical and clinical significance of the results. Methods: Computed tomography (CT) data of 200 patients who received a lower extremity CT angiography examination were selected for the three-dimensional CT (3D CT) reconstruction of bilateral femurs by using Mimics software. The 3D axis of the femoral neck was built, and the FNTAs of the isthmus and the basilar part were measured using the “inertia axes” method. SPSS software was used for statistical analyses. Results: The difference in FNTA was statistically significant between the isthmus and the basilar part (isthmus 30.58 ± 8.90° vs. basilar part 23.79 ± 3.98°; p < 0.01). Significant differences in the FNTA were observed between the sexes (males 31.99 ± 9.25° vs. females 27.49 ± 7.19°; p < 0.01). The increase in FNTA from the basilar part to the isthmus was 6.79 ± 8.06°, and the increase observed in men (7.87 ± 8.57°) was larger than that in women (4.44 ± 6.23°, p < 0.01). However, no significant differences in the values were observed between sides. According to the correlation analysis, height exerted the greatest effect on the FNTA (r = 0.255, p＜0.001), and the stepwise linear regression analysis produced the following final regression model: Y = -27.685 + 35.134 × HEIGHT (p < 0.001, R2 = 0.095). Conclusions: This study provides a new and reliable 3D method for measuring the FNTA. The method and results provide a methodological foundation and theoretical support for the research and development of internal fixation devices and configurations of the space for an implant designed to treat a femoral neck fracture. And, the optimal opening point of the femoral medullary cavity is recommended to be located at the posterior position of the top of the femoral neck cross-section during hip replacement.