An interventional study of Smooth pursuit neck torsion test and Visual Analogue Scale in Ocular Motor Detectation, Vestibular and Cervicogenic Dizziness, sponsored by Kaohsiung Medical University. Completed at 1 site in Taiwan. Open to participants aged 20 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-28.
Sponsored by Kaohsiung Medical University · Not applicable, Interventional, and Screening
Phase 1：System Development and Validation A custom-made eye movement detection system was developed to quantify smooth pursuit eye movements under multiplanar neck postures. The initial study established the reliability and measurement consistency of ocular motor parameters, including Gain, SPNTD, Accuracy, and Latency, in healthy individuals. The findings demonstrated acceptable-to-excellent reliability and confirmed the feasibility of assessing ocular motor performance across multiple cervical planes.
Phase 2：Clinical Application in Mechanical Neck Pain Based on the validated system developed in Phase 1, the present study investigates multidimensional oculomotor and cervical sensorimotor function in individuals with upper mechanical neck pain (MNP). By comparing MNP patients with asymptomatic controls, the study aims to identify sensitive oculomotor biomarkers associated with cervical sensorimotor dysfunction and to explore whether multi-axis ocular motor assessment provides additional clinical information beyond conventional cervical proprioception and range-of-motion measures.
Phase 1 Reliability and Performance Evaluation of a Custom-Made Oculomotor Detection System Across Multiplanar Neck Positions
The integration of cervical proprioceptive input, visual information, and vestibular signals plays an essential role in gaze stabilization and sensorimotor control. Previous studies have suggested that alterations in cervical afferent input may influence oculomotor performance and contribute to symptoms such as dizziness and impaired visual stability. However, most conventional smooth pursuit assessments have been restricted to a single rotational axis, primarily focusing on horizontal neck torsion positions and velocity-based parameters.
To address these limitations, a custom-made oculomotor detection system was developed to quantify smooth pursuit eye movements under multiple cervical orientations. The system was designed to evaluate eye movement performance across different neck planes, including neutral posture, lateral flexion, flexion-extension, and rotational positions. Multiple ocular motor parameters were incorporated to provide a multidimensional assessment framework, including pursuit Gain, Smooth Pursuit Neck Torsion Difference (SPNTD), Accuracy, and Latency.
The primary objective of this study was to evaluate the measurement performance and reliability of the custom-made system in healthy individuals. Specifically, the study aimed to determine the consistency of ocular motor parameters across repeated measurements and to investigate whether different neck positions influence smooth pursuit tracking performance. Reliability was assessed using intraclass correlation coefficients (ICC), while differences among cervical orientations were analyzed using non-parametric statistical methods.
The findings of this study established the technical feasibility and reliability of the custom detection system and provided preliminary normative data regarding ocular motor performance under multiplanar cervical conditions. These results support the use of the system as a research and clinical assessment tool for evaluating cervical-ocular sensorimotor interactions.
Phase 2 Characterizing Multidimensional Oculomotor and Cervical Sensorimotor Function in Individuals With Upper Mechanical Neck Pain
Mechanical neck pain (MNP) is a common musculoskeletal disorder that may be associated with disturbances in cervical sensorimotor integration. Although conventional clinical assessments such as cervical range of motion and joint position error testing are frequently used to evaluate cervical function, these measures may not fully capture subtle impairments in cervical-ocular sensorimotor control. Increasing evidence suggests that altered cervical proprioceptive input may influence eye movement control and contribute to visual disturbances, impaired gaze stability, and symptoms related to cervical dizziness.
Building upon the validated oculomotor detection system established in the preceding reliability study, the present investigation aims to explore multidimensional ocular motor function in individuals with upper mechanical neck pain. Unlike conventional smooth pursuit neck torsion assessments that primarily examine a single rotational plane, this study utilizes a multi-axis assessment framework to evaluate ocular motor performance across multiple cervical orientations. In addition to velocity-based measurements, spatial and temporal parameters are incorporated to provide a comprehensive characterization of oculomotor behavior.
Participants with upper mechanical neck pain and asymptomatic controls undergo assessments of cervical sensorimotor function, including cervical range of motion and joint position error testing, followed by ocular motor evaluations performed under seven different neck positions. Oculomotor performance is quantified using pursuit Gain, Smooth Pursuit Neck Torsion Difference (SPNTD), Angular Error, Pursuit Latency, and temporal synchronization parameters derived from cross-correlation analyses. These outcome measures are intended to capture complementary aspects of ocular motor control, including velocity matching, spatial tracking accuracy, torsion-related modulation, and temporal coordination.
The primary objective of this study is to identify ocular motor parameters that may distinguish individuals with upper mechanical neck pain from asymptomatic controls and to determine whether multidimensional oculomotor assessment provides additional information beyond conventional cervical measures. The study further seeks to investigate the influence of cervical orientation on ocular motor performance and to characterize potential alterations in cervical-ocular sensorimotor integration associated with mechanical neck pain.
Findings from this study are expected to contribute to a better understanding of cervical sensorimotor dysfunction and may facilitate the development of clinically useful biomarkers for identifying subtle oculomotor abnormalities in individuals with neck pain. Furthermore, the results may provide a foundation for future investigations involving patients with cervicogenic dizziness and other disorders characterized by impaired cervical-ocular sensorimotor control.
Kaohsiung Medical University is the lead sponsor of 55 studies on the registry; 16 are open to participants now.
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Used custom-made ocular motor system to adjust the neck postures of participants, to examine the reliability of data and compared the pursuit ability in three different neck motion planes, seven different neck postures.
Device: Smooth pursuit neck torsion test · Other: Visual Analogue Scale · Device: Craniovertebral Angle · Device: Joint Position Error
Participants with upper mechanical neck pain will undergo multidimensional cervical sensorimotor and oculomotor assessments. Evaluations include cervical range of motion, joint position error testing, and smooth pursuit eye movement tasks performed under multiple neck orientations to investigate cervical-ocular sensorimotor function
Device: Smooth pursuit neck torsion test · Other: Visual Analogue Scale · Device: Craniovertebral Angle · Device: Joint Position Error
Used custom-made system to stimulate the procedure of smooth pursuit neck torsion test in the current study, the multiple axis motion platform can adjust the neck postures to three different neck motion planes, seven different neck postures.
A 10-cm visual analogue scale used to assess pain intensity during standardized palpation of the upper cervical spine (C1-C3) and suboccipital region. Recorded for average, right, and left sides.
A measure of forward head posture; the angle formed between a horizontal line and a line connecting the tragus of the ear to the spinous process of C7.
Assessed in sitting using a laser-pointer repositioning task with a target 90 cm in front of the participant at eye level. Participants actively moved their head in a randomized direction and then attempted to return to the neutral (target) position without visual feedback. Repositioning error was defined as the absolute angular deviation of the laser point from the target center, expressed in degrees. Six trials were performed per direction and averaged.
Analyzied the reliability of custom-made ocular motor detectation system
The custom-made system would output four parameters in this study. Used Intraclass correlation coefficient (ICC) to examine the reliability of pursuit parameters.
Time frame: From enrollment to the end of research at 1 day.
Examine the pursuit ability in seven different neck postures.
A custom-made system would change the neck posture in seven different neck postures. Used nonparametric(Friedman test) to analyze the pursuit ability in seven different neck postures, if the results were significant(p-value less than 0.05), used Wilcoxon sign rank to be the posthoc test.
Time frame: From enrollment to the end of treatment at 1 day
Plan to share: Yes — Individual information(e.g age, born, research date) Personal pursuit ability results in the current study, like pursuit synchronized in each neck posture, the difference of pursuit synchronized in each neck motion plane, pursuit accuracy, potential pursuit reaction time.
Supporting information: Study protocol, Sap, Icf, Csr, Analytic code
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Kaohsiung Medical University