Abstract
Purpose/Hypothesis: The purpose of this research was to determine the standing balance sway index and cervical kinesthetic awareness in patients experiencing a CEH, and compare these scores to existing normative data. Balance and kinesthetic awareness systems are anatomically linked to the somatosensory system. Due to the close relationship of these systems, it is hypothesized that cervicogenic headaches will be accompanied by a dysfunction in balance and kinesthetic awareness. Subjects: A total of 21 subjects were recruited from outpatient physical therapy clinics and Florida Gulf Coast University College of Health Professions and College of Nursing in southwest Florida. There were thirteen females and eight males with an age range of 18-5 7 years old with an average age of thirty-five years old. All subjects were diagnosed by a CEH by a licensed physical therapist using the International Headache Study Group's CEH diagnostic criteria. The average pain for a CEH from the twenty-one participants was 5. 8/10. The last episode of a CEH occurred from one month ago to the day of testing; with five out of the twenty-one participants having a CEH sometime during the day of testing. Materials/Methods: The Biodex Balance System SD was used to assess balance through the modified Clinical Test of Sensory Integration and Balance (m-CTSIB). This standardized test involved four conditions, which challenged different aspects of the individuals balance mechanisms. Each condition was held tor thirty seconds as the Biodex Balance System SO calculated the subjects sway index and stability index. A cervicocephalic kinesthetic sensibility test previously used by Revel, Andre-Deshays, & Minguet (1991) was administered to the subjects. The exam involved assessing the abilities of a blindfolded subject to reproduce a neutral head position after moving the head and neck through three cardinal planes of motion. Results: The averages of each of the assessments were described according to the normative data set for each assessment tool. The average M-CTSIB sway index tor subjects with a CEH was above the highest normal value for three of the four conditions. The largest difference in balance was noted in the fourth testing position, standing on foam with eyes closed. The average kinesthetic awareness score of subjects with CEH were within a normal range. No significant correlations were found between deficits in balance and kinesthetic awareness in patients with CEH. Conclusions: The results of this study demonstrate that patients with CEH have deficits in standing balance, specifically with challenging the vestibular system. This study did not conclude a deficit in kinesthetic awareness in patients with CEH. Clinical Relevance: Balance results may provide a physical therapist an objective measure to monitor throughout the rehabilitation tor a patient with CEH. Balance training in conjunction with the traditional treatment methods for CEH may improve patient outcomes. Kinesthetic awareness should not be excluded from an examination of patients with CEH, even though the results of this study did not conclude a deficit in kinesthetic awareness when comparing patients with CEH to the normal population. Kinesthetic awareness deficits may occur in patients with CEH and neck pain, which might indicate impairments in proprioception.