Execution
- 1Position the patient sitting with a laser pointer attached to the head or a similar head-position tracking setup.
- 2Mark the neutral head position on a target at a standardized distance.
- 3Ask the patient to close the eyes, rotate, flex, or extend the head, and return to the perceived neutral starting position.
- 4Measure the distance or angular error between the returned position and the original neutral target.
- 5Repeat multiple trials in each direction and compare errors with expected values or side-to-side patterns.
Positive outcome
The test is positive for cervical proprioceptive impairment when repositioning error is excessive, commonly greater than about 4.5° in many clinical protocols. Direction-specific errors may help identify symptomatic movement planes. It is not specific for cervicogenic dizziness because neck pain, whiplash, concussion, vestibular dysfunction, and age can all affect performance.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Treleaven et al. (2006) | sensorimotor control study | NA | NA | NA | NA |
| Chen et al. (2013) | neck torsion modification study | NA | NA | NA | NA |
CommentCervical JPE is useful for documenting proprioceptive impairment, especially after whiplash or in persistent neck-related dizziness. It does not distinguish cervicogenic dizziness from vestibular or central causes on its own. It is best used alongside vestibular testing, oculomotor screening, and symptom behavior.
Low Clinical Value