Aging Clin Exp Res, Vol. 20, No. 4 1
Key words: Aging, cervical joint position sense, cervicocephalic relocation test to neutral head position, proprioception.
Correspondence: Nicolas Vuillerme, PhD, Laboratoire TIMC-IMAG, UMR UJF CNRS 5525, Faculté de Médecine, 38706 La Tronche cédex,
France.
E-mail: nicolas.vuillerme@imag.fr
Received April 18, 2007; accepted in revised form August 17, 2007.
Cervical joint position sense is impaired
in older adults
Aging Clinical and Experimental Research
Nicolas Vuillerme, Nicolas Pinsault, and Benjamin Bouvier
Laboratoire TIMC-IMAG, UMR UJF CNRS 5525, La Tronche, France
ABSTRACT. Background and aims: Although the
role of afferent input from cervical muscles on the con-
trol of posture and locomotion is recognised, it is sur-
prising that there is an absence of data reporting
whether joint position sense at the cervical level is
impaired in older healthy adults. The present experi-
ment was designed to address this issue. Methods:
Eighteen young (mean age= 23 yrs) and 18 older
healthy adults (mean age= 68 yrs) were asked to per-
form the cervicocephalic relocation test (CRT) to the
neutral head position (NHP), that is, to relocate the
head on the trunk, as accurately as possible, after ac-
tive cervical rotation to the left and right sides. Ten tri-
als were performed for each rotation. Absolute and
variable errors were used to assess cervical joint repo-
sitioning accuracy and consistency, respectively. Re-
sults: Less accurate and less consistent repositioning
performances were observed in older adults than in
young adults, as indicated by increased absolute and
variable errors, respectively. Conclusions: The present
findings show that cervical joint position sense, as-
sessed through the CRT to the NHP, is impaired in old-
er adults.
(Aging Clin Exp Res 2008; 20: ###-###)
©
2008, Editrice Kurtis
repositioning errors made by young healthy adults were
compared with those made by older healthy adults, when
performing the cervicocephalic relocation test (CRT) to the
neutral head position (NHP) (15-17).
METHODS
Participants
Eighteen young adults (age= 23±2 yrs; body weight=
61±15 kg; height= 171±9 cm; mean±SD) and 18 older
adults (age= 68±7 yrs; body weight= 74±11 kg; height=
169±9 cm; mean±SD) voluntarily participated in the
experiment. They gave their informed consent to the
experimental procedure as required by the Helsinki dec-
laration (1964) and the local Ethics Committee. Sub-
jects were healthy, without any history of cervical pain,
whiplash injury, headache, trauma, operation on the
cervical spine, or neurological disorders.
Procedures
The experimental procedure of this test (16), which has
recently demonstrated excellent test-retest reliability (17),
is illustrated in Figure 1.
Blindfolded subjects were seated on a chair with a
backrest at a distance of 3 meters from a white wall, with
their head in a neutral position. They were asked to re-
locate their head on the trunk to the NHP with maximum
precision, without any instructions regarding speed, after
active head movement performed in the horizontal plane
within comfortable limits. Subjects had a laser pointer at-
tached on the head and a handheld button to switch it on
to materialize their NHP before (Point O; Fig. 1, upper
panel) and after (Point G; Fig. 1, lower panel) head re-
location.
Ten trials were executed after one right head rotation
and ten after one left head rotation. Right and left head ro-
tations were randomized over subjects. No feedback was
given to them about their actual performance.
The video recorded during the session contained all
laser impacts characterizing head positions before and af-
INTRODUCTION
Age-related deterioration in the proprioceptive sys-
tem is well documented (e.g., 1 for a review). Previous
studies have reported that older adults exhibit marked joint
position sense impairment, measured at the ankle (2,
3), knee (4-8), trunk (9), elbow (10) and finger (11) levels,
as a result of normal aging. At this point, however, al-
though the role of afferent input from cervical muscles on
the control of posture and locomotion is recognised
(e.g., 12-14), it is surprising that there is an absence of da-
ta reporting whether joint position sense at the cervical
level is impaired in older healthy adults. The present ex-
periment was designed to address this issue, and head
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