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.