Manual Therapy 13 (2008) 266–275 Case Report Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control—Part 2: Case studies Julia Treleaven Neck Pain and Whiplash Research Unit, Division of Physiotherapy, University of Queensland, Brisbane, Q1d 4072, Australia Received 8 October 2007; accepted 8 November 2007 Abstract Recent research highlights sensorimotor control disturbances in those with neck disorders. Assessment and management of the symptoms of dizziness, altered cervical proprioception, eye and head co-ordination and disturbances to postural stability in those with neck disorders are important and are presented in a companion article. In this paper, four case studies are presented to illustrate the formulation and use of a tailored program designed to retrain balance, cervical proprioception and eye and head movement control in those with neck disorders. This program should be used in conjunction with a multi-modal approach to the management of neck disorders. Such a combined approach should address causes of abnormal cervical afferent input as well as the important links between the cervical, vestibular and ocular systems and adaptive changes in the sensorimotor control system. r 2007 Elsevier Ltd. All rights reserved. Keywords: Sensorimotor; Eye; Head; Postural stability; Cervical; Management; Case studies 1. Introduction In the preliminary article to this paper, the theoretical framework for the assessment and management of sensorimotor control disturbances affecting postural stability, head and eye movement control in neck disorders was presented. (Treleaven, 2007) Such dis- turbances are thought to be resultant of abnormal cervical afferent input and subsequent changes to the integration, timing and tuning of sensorimotor control. Recommendations for clinical assessment and manage- ment of such sensorimotor control disturbances in neck pain were presented based on the evidence available to date (Treleaven, 2007). This highlighted the need for a combined approach to address not only the possible causes of abnormal cervical afferent input, such as pain, inflammation, altered muscle spindle sensitivity and functional impairment and morphological changes of neck musculature, but to also consider the important links between the cervical, vestibular and ocular systems and any adaptive changes in the sensorimotor control system. Thus, local cervical treatment in conjunction with tailored programs including cervical joint position retraining, gaze stability and eye–head co-ordination exercises as well as walking and balance training to improve sensorimotor control in patients with neck pain was recommended. The current paper presents a series of case studies to specifically illustrate the formulation and use of the tailored program designed to retrain the sensory and motor aspects of sensorimotor control in those with neck pain. The case studies also highlight the assessment of sensorimotor control in neck pain including investigation of the symptoms of dizzi- ness and unsteadiness, cervical joint position error (JPE), balance and oculomotor control and presents considerations for other possible causes of such dis- turbances. Particular emphasis is placed on the tailored program in the case studies to illustrate its use, but this should always be incorporated into a multi-modal approach. The tests used in the assessment of sensorimotor control and the specifics of the tailored exercises are ARTICLE IN PRESS www.elsevier.com/locate/math 1356-689X/$ - see front matter r 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.math.2007.11.002 E-mail address: j.treleaven@shrs.uq.edu.au