Head repositioning accuracy in patients with neck pain and asymptomatic subjects: concurrent validity, influence of motion speed, motion direction and target distance

Background: Cervicocephalic kinesthetic deficiencies have been demonstrated in patients with chronic neck pain (NP). On the other hand, authors emphasized the use of different motion speeds for assessing functional impairment of the cervical spine. Purpose: The objectives of this study were (1) to investigate the head repositioning accuracy in NP patients and control subjects and (2) to assess the influence of target distance, motion speed, motion direction and pain. Materials and methods: Seventy-one subjects (36 healthy subjects and 35 NP patients; age 30–55 years) performed the head repositioning test (HRT) at two different speeds for horizontal and vertical movements and at two different distances. For each condition, six consecutive trials were sampled. Results: The study showed the validity and reproducibility of the HRT, confirming a dysfunctional threshold of 4.5°. Normative values of head repositioning error up to 3.6° and 7.1° were identified for healthy and NP subjects, respectively. A distance of 180 cm from the target and a natural motion speed increased HRT accuracy. Repositioning after extension movement showed a significantly larger error in both groups. Intensity, duration of pain as well as pain level did not significantly alter head repositioning error. Conclusions: The assessment of proprioceptive performance in healthy and NP subjects allowed the validation of the HRT. The HRT is a simple, not expensive and fast test, easily implementable in daily practice to assess and monitor treatment and evolution of proprioceptive cervical deficits.

Outer crust of a cold non-accreting magnetar

The outer-crust structure and composition of a cold, non-accreting magnetar are studied. We model the outer crust to be made of fully equilibrated matter where ionized nuclei form a Coulomb crystal embedded in an electron gas. The main effects of the strong magnetic field are those of quantizing the electron motion in Landau levels and of modifying the nuclear single-particle levels producing, on average, an increased binding of nucleons in nuclei present in the Coulomb lattice. The effect of a homogeneous and constant magnetic field on nuclear masses has been predicted by using a covariant density functional in which induced currents and axial deformation due to the presence of a magnetic field that breaks time-reversal symmetry have been included self-consistently in the nucleon and meson equations of motion. Although not yet observed, for Ba 1016 G both effects contribute to produce different compositions - odd-mass nuclei are frequently predicted - and to increase the neutron-drip pressure as compared to a typical neutron star. Specifically, in such a regime, the magnetic-field effects on nuclei favor the appearance of heavier nuclei at low pressures. As B increases, such heavier nuclei are also preferred up to larger pressures. For the most extreme magnetic field considered, B=1018 G, and for the models studied, almost the whole outer crust is made of 4092Zr52.