Neck Orthopaedic Test: Cervical Flexion-Rotation Test

The Cervical Flexion-Rotation Test is a clinical exam used to assess the mobility and dysfunction of the upper cervical spine, particularly at the C1-C2 motion segment. This test is commonly used by healthcare professionals, such as chiropractors and physical therapists, to help diagnose and treat patients with neck pain or cervical spine disorders.

Here is a step-by-step procedure when performing the Cervical Flexion-Rotation Test:

1. Ask the patient to sit upright in a chair with their feet flat on the ground.
2. Instruct the patient to keep their shoulders relaxed and their head in a neutral position.
3. Stand behind the patient and place one hand on their forehead and the other hand on their shoulder.
4. Gently rotate the patient's head to one side, keeping their chin level.
5. Ask the patient to flex their chin towards their chest, while maintaining the rotated position.
6. Measure the degree of rotation achieved by the patient using a goniometer or other measuring tool.
7. Repeat the test on the other side, rotating the patient's head in the opposite direction.
8. Compare the degree of rotation on each side and note any pain or discomfort experienced by the patient.

It is important to be gentle and cautious while performing this test, as excessive force or manipulation can cause further injury or discomfort. If the patient experiences pain or discomfort during the test, it should be stopped immediately and the patient should be re-evaluated. 

References:

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2. Murphy DR, Hurwitz EL. A theoretical model for the development of a diagnosis-based clinical decision rule for the management of patients with spinal pain. BMC Musculoskelet Disord. 2007;8:75. doi: 10.1186/1471-2474-8-75.
3. Côté P, Cassidy JD, Carroll L. The Saskatchewan Health and Back Pain Survey: the prevalence of neck pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998;23(15):1689-1698. doi: 10.1097/00007632-199808010-00015.
4. Cook C, Brismée JM, Sizer PS Jr. Relationship between chief complaint and cervical spine mobility in patients with mechanical neck pain. J Manipulative Physiol Ther. 2006;29(4):288-292. doi: 10.1016/j.jmpt.2006.03.005.
5. Dunning JR, Cleland JA, Waldrop MA, Arnot CF, Young IA, Turner M. Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2012;42(1):5-18. doi: 10.2519/jospt.2012.3894.