Smooth pursuit neck torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety.

OBJECTIVE The smooth pursuit neck torsion test is thought to be a measure of neck afferent influence on eye movement control and is useful in assessing subjects with whiplash, especially those complaining of dizziness. Nevertheless, it is not known whether impairments identified relate only to abnormal cervical afferentation or are influenced by levels of anxiety or neck pain. DESIGN A prospective, 3-group, observational design. SUBJECTS One hundred subjects with persistent whiplash (50 complaining of dizziness, 50 not complaining of dizziness) and 50 healthy controls. METHODS The smooth pursuit neck torsion test was performed and analysed taking into account subjects' reported levels of pain, anxiety and dizziness. RESULTS The results confirm that there are significant (p<0.01) differences in the smooth pursuit neck torsion test between subjects with persistent whiplash both with dizziness (mean 0.11) and without dizziness (mean 0.07) compared with healthy control subjects (mean 0.01). The results suggest that the test is not influenced by a patients' level of anxiety, but may be influenced by both nocioceptive and proprioceptive factors. CONCLUSION The results provide further evidence of the usefulness of the smooth pursuit neck torsion test to identify eye movement disturbances in patients with whiplash, which are likely to be due to disturbed cervical afferentation.