SPINE Volume 35, Number 17, pp 1589 –1594 ©2010, Lippincott Williams & Wilkins Effects of Vision and Tactile Stimulation of the Neck on Postural Control During Unperturbed Stance and Cervical Joint Position Sense in Young Asymptomatic Adults Nicolas Pinsault, PhD, PT,*† Benjamin Bouvier, PT,† Yannick Sarrazin, PT,† and Nicolas Vuillerme, PhD*‡ Study Design. Before and after intervention trials. Objective. To evaluate the effects of visual input and tactile stimulation of the neck on postural control during unperturbed stance and cervical joint position sense. Summary of Background Data. Although beneficial ef- fects on lower-limb joints proprioception have been reported when vision was available and when tactile stimulation was applied around lower-limb joints, there has hitherto been no study investigating whether and how vision and tactile stim- ulation applied to the neck could modify postural control during unperturbed stance and joint position sense. Methods. The effects of visual input and tactile stimu- lation of the neck on postural control during unperturbed stance (Experiments 1 and 2) and cervical joint position sense (Experiments 3 and 4) were assessed in four sepa- rate experiments. During these experiments, two experi- mental tasks (a postural task during unperturbed stance and the CRT to NHP) were executed without (No vision) and with the availability of the vision (Vision) and without (No tactile stimulation condition) and with the application of strips of adhesive bandage to the skin over and around the neck (Tactile stimulation condition). Twelve different subjects participated in the four experiments. Results. For experiments 1 and 2, decreased centre of foot pressure displacements were observed in the Vision relative to the No vision and in the Tactile stimulation relative to the No tactile stimulation condition. For exper- iments 3 and 4, more accurate and more consistent repo- sitioning performances were observed in the Vision rela- tive to the No vision and in the Tactile stimulation relative to the No tactile stimulation condition, as indicated by decreased absolute and variable errors, respectively. Conclusion. Altogether, our results suggest that sub- jects were able to take advantage of vision and increased neck cutaneous information provided by the by strips of adhesive bandage applied to the neck to improve postural control during unperturbed stance and cervical joint posi- tion sense. Key words: neck, cutaneous, vision, proprioception, balance. Spine 2010;35:1589 –1594 It is now well recognized that vision 1 and neck somato- sensation 2 play a major role in the control of human upright posture. Indeed, previous studies have reported an improvement of postural control when visual inputs are available and reliable. 3 In contrast, other previous studies have reported an alteration of postural control when the reliance of cervical proprioceptive information was impaired by pathology, trauma, or injury, 4–6 or in healthy subjects by experimental manipulations, such as neck muscles vibration, 7,8 neck muscles fatigue, 9,10 or neck pain. 11 Although physiologists generally agree that muscle and joint afferents are the main contributors to proprioception, 12,13 numerous studies have used brace or bandage, directly applied on the skin around joint, as tools for assessing the contribution of cutaneous infor- mation on proprioception and postural control during unperturbed stance in young healthy adults. Interest- ingly, although beneficial effects have been reported on lower-limb joints proprioception when vision was avail- able 14 and when tactile stimulation was applied, 15–18 there has hitherto been no study investigating whether and how tactile stimulation applied to the neck could modify postural control during unperturbed stance and cervical joint position sense, and whether and how the availability of visual information could modify cervical joint position sense in asymptomatic individuals. The objective of this study was thus to evaluate the effects of visual input and tactile stimulation of the neck on postural control during unperturbed stance and cer- vical joint position sense in young asymptomatic adults. It was hypothesized that both vision and tactile stimula- tion of the neck would improve postural control during unperturbed stance (hypothesis 1) and cervical joint po- sition sense (hypothesis 2). Materials and Methods Subjects Twelve young asymptomatic male university students (Table 1) participated in the 4 separate experiments of the present study. Criteria for selection and inclusion were male gender, aged 20 to 30 years. Exclusion criteria were sagittal and/or coronal alignment of the neck impairment, history of motor problem, neck pain, neurologic disease, or vestibular impair- ment. All subjects were examined by an ophthalmologist and From the *AFIRM and AGIM3 Teams, TIMC-IMAG Laboratory, UMR UJF CNRS 5525, La Tronche, France; †Ecole de Kine ´sithe ´rapie, CHU Grenoble, France; and ‡CIC-IT 805, INSERM/AP-HP, Raymond Poincare Hospital, EA 4497, Garches, France. Acknowledgment date: March 24, 2008. Revision date: June 10, 2009. Acceptance date: July 13, 2009. The manuscript submitted does not contain information about medical device(s)/drug(s). Ministere de l’ Enseignement National et de la Recherche Tech- nologique francais funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript. Supported by the Ministe `re de l’Enseignement National et de la Re- cherche Technologique franc ¸ais (21528 –2006). Address correspondence and reprint requests to Nicolas Vuillerme, PhD, AFIRM and AGIM3 Teams, TIMC-IMAG Laboratory, UMR UJF CNRS 5525, Faculty of Medicine, 38706 La Tronche cedex, France; E-mail: nicolas.vuillerme@imag.fr 1589