Head-Neck Differentiation Test | Cervicogenic Dizziness
the premise behind neck torsion is that by holding the neck still and rotating the trunk, there is isolated stimulation of cervical afferents. Thus if the test is positive, a cervicogenic cause of the dizziness is more likely.
Trealeaven et al. (2019) performed the head-neck differentiation this test in a group of healthy subjects to determine the test’s specificity. They found a specificity of 90% in patients during the torsion part of the test. As sensitivity values first have to be evaluated in symptomatic groups, the clinical use of this test is unknown at this moment.
To perform the test, have the patient seated on a swivel chair with his eyes closed and the hip and knees flexed to 90 degrees.
Then, the examiner fixates the patient’s head in neutral position and asks the patient to actively rotate the trunk with the help of his legs to the left and right side for 45° at a metronome pace of 60 beats per minute.
This test is scored positive if the patient reports dizziness, visual disturbances, unusual eye movements after opening the eyes after the test, speech disturbance, motion sickness or nausea, slurred speech, dysphagia, light-headedness, tinnitus, headache, or paresthesia. These symptoms can occur during any of the four positions or immediately after the test.
Next to the Head-Neck Differentiation Test, your dizziness exam should include the following assessments:
- Gaze stability
- Saccadic Eye Movement
- Eye-Head Coordination
- Postural Stability
- Joint Position Sense Error
- Smooth Pursuit Neck Torsion Test
- Cervical Torsion Test
Treleaven, J., Joloud, V., Nevo, Y., Radcliffe, C., & Ryder, M. (2020). Normative responses to clinical tests for cervicogenic dizziness: Clinical cervical torsion test and head-neck differentiation test. Physical Therapy, 100(1), 192-200.
- Andreas Johnson24/10/23Vestibular Rehabilitation GREAT COURSE
This course is super informative and detailed. I have learned a ton and feel confident in beginning to assess and treat vestibular clients.Mads Louis25/11/22Vestibular Rehabilitation EXCELLENT COURSE, THAT MAKES YOU READY TO TREAT DIZZINESS WITH CONFIDENCE
This course provides an excellent opportunity to learn how to treat and diagnose vertigo/dizziness patients, who previously were a mystery to treat.Andreas Johnson24/10/22Vestibular Rehabilitation GREAT COURSE
This course is super informative and detailed. I have learned a ton and feel confident in beginning to assess and treat vestibular clients.
- Jordi Holierhoek18/08/22Vestibular Rehabilitation EXCELLENT COURSE!
Fantastic course, very practical with enough depth! I learned a lot from first. He is an excellent teacher who knows his stuff. I would totally recommend this course.Stephen08/08/22Vestibular Rehabilitation GREAT COURSE FOR BEGINNERS AND THERAPISTS WITH SOME EXPERIENCE
Loved the course, can be done relatively quickly if you are like me and have a little bit of vestibular knowledge (it took me around 2 weeks), but the basics are all there so you can spend a bit more time getting into it if needed
I luckily had two patients in my ward needing vestibular rehabilitation just as I had finished this course, and I was able to help them straight awayKim Hansen30/03/22Vestibular Rehabilitation VESTIBULAR REHABILITATION
Really good and professional layout with Firat's professional experience as well as nice software touches by Physiotutors with questions in some videos for example. Firat approaches you in different ways of teaching with small videos, summaries, lectures and so on. Also fun to see that some of his references are people that I have a cooperation with here in Sweden. Even if there’s a whole division of information regarding vestibular hypofunction it would still be fun to have separate chapter for vestibular neuritis, but that’s just a small note. On the whole I’m totally happy and satisfied with this course, really good job done by Firat and Physiotutors, I will be keeping an eye out for more advanced courses in the future regarding this topic, maybe Firat can do a Masterclass version?
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you won’t be disappointedMarine Gandin27/01/22Vestibular Rehabilitation REALLY COMPLETE COURSE AND EASY TO LEARN
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I didn’t need any further explanation but I saw that Firat answers very fast to the question on the unit.
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Thanks!Christiena den Tek28/12/21Vestibular Rehab COMPLETE COURSE ABOUT DIZZINESS AND THE WAY TO TREAT FOR PHYSIO'S
In the past I finished/followed a few courses about dizziness and treatment. I really enjoyed following this course because it’s very complete. There is overall information about the systems involved with dizziness problems, the pathologies, the exams and the overall physiotherapy treatment or other treatments. There is a nice mix between the way the information is given and the information is up to date science. The teacher (Firat) is a teacher that loves helping you out and if you have any questions he is quickly in his response.
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The learning experience is enhanced by interactive material found in each module.
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This is an excellent course, and I would definitely recommend it!Physiotutors27/08/21Vestibular Rehabilitation Firat really delivered on this course! While we have had some training in vestibular diagnostics and rehab in our own training, this course is on a whole other level! Building this course with Firat has increased our knowledge dramatically and we can absolutely recommend this course to any Physiotherapist as patients with vestibular problems will be among the most grateful patients when treated right.Anne Cahill02/08/21Vestibular Rehabilitation Thank You!!
This is a brilliant course. The learning materials are concise, clear and comprehensive. All the information given is easy to navigate, up to date and very useful for daily clinical vestibular rehabilitation practice. It is a much appreciated educational resource. Amazing!! Thank you for this excellent course.
- Astrid Schubart27/06/21Vestibular Rehabilitation I finished this course Vertigo this weekend and it’s been a long time since I’ve done such a great structured training. Lots of practical content. The lecturer shows in detail what is important. Firat Kesgin offers a lot of additional information and patient information.
I am really excited and looking forward to apply my new knowledge in practice.