Smooth Pursuit Neck Torsion Test (SPNT) | Dizziness Assessment
Neck torsion may lead to greater postural deficits in individuals with persistent traumatic neck pain due to abnormal cervical afferent input. The Smooth pursuit neck torsion test abbreviated as SPNT helps to determine the presence of disturbances in eye movement and postural stability. It is thought to test proprioceptive function, particularly for controlling static and dynamic head and neck positions.
Tjell et al. (1998) found a sensitivity of 90% and a specificity of 91% in a group of traumatic neck pain patients with dizziness compared to a mixed group of patients with vertigo, central nervous system findings, Meniere’s disease, and healthy subjects. Although it seems to have high accuracy to diagnose cervicogenic dizziness, it is the only study evaluating this test so far. For this reason, we give it a moderate clinical value in practice.
To conduct the SPNT the patient is in a sitting position on a moving stool. The patient’s head is kept in a horizontal position and the head rotation is introduced to a maximum of 45° by turning the patient’s chair. The therapist instructs the patient to trace a slowly moving target with his eyes in right or left horizontal direction while the patient’s head is kept steady. This test is done in neutral torso position, torso turned to the right, and torso turned to the left side. This test is positive in the clinical setting in case dizziness is reproduced in the torsion position compared to neutral. Be aware that in a laboratory setting, the outcome measure is the velocity of the corrective saccades which can only be done with special instruments.
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Next to the Smooth Pursuit Neck Torsion Test, your dizziness exam should include the following assessments:
- Gaze stability
- Saccadic Eye Movement
- Eye-Head Coordination
- Postural Stability
- Joint Position Sense Error
- Cervical Torsion Test
- Head-Neck Differentiation Test
Tjell C (1998). Smooth pursuit neck torsion test: a specific test for cervical dizziness. Ann J Otol, 19, 76-81.
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- 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.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
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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?Steve van Rijen26/03/22Vestibular Rehabilitation VESTIBULAR REHABILITATION
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you won’t be disappointedMarine Gandin27/01/22Vestibular Rehabilitation REALLY COMPLETE COURSE AND EASY TO LEARN
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- 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.
I would recommened this course highly not only for those who just start learning things about the dizziness (patient) but also for those who are already working with these patients.Elisabetta12/12/21Vestibular Rehabilitation INCREDIBLY THOROUGH COURSE
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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.
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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.