The Flexion-Rotation Test performed actively and passively
Facet joints at the occiput/ C1, C1/ C2 and C2/ C3 have been found to refer localized symptoms to the occipital and suboccipital region, which can be associated with cervicogenic headache (CH). The critera for diagnosis of CH is the cervical range of motion (ROM) which includes active cervical ROM, passive intervertebral joint play and passive ROM specifically at the C1/ C2 spinal segments in patients with CH.
The Flexion-Rotation Test (FRT) has been described as a method to differentiate rotational motions taking place at the upper versus lower cervical spine.
The aim of this study was to examine upper cervical rotation ROM in individuals with CH compared to asymptomatic participants using the cervical flexion rotations test passive and active. Twelve patients with CH and asymptomatic individuals were included in the study to compare ROM between sides for these two versions of the test. Cervical rotation was measured in a position of full cervical flexion for both tests.
The passive FRT has high levels of sensitivity and specificity. The passive FRT can reveal limitations in ROM toward the side of symptoms in individuals with CH, the active FRT failed to reveal such ROM discrepancies. There was also a greater degree of ROM available with the passive FRT compared to the active FRT, which may be related to the neutral and elastic zones of motions. This study advises clinicians to use the passive FRT to detect the presence of CH.
> From: Bravo Petersen et al., J Man Manip Ther (2015) (Epub ahead of print). All rights reserved to W.S. Maney & Sons Ltd. Click here for the Pubmed summary.