Abstract
BackgroundThe craniocervical flexion test (CCFT) is recommended when examining patients with neck pain related conditions and as a deep cervical retraining exercise option. During the execution of the CCFT the examiner should visually assess that the amount of craniocervical flexion range of motion (ROM) progressively increases. However, this task is very subjective. The use of inertial wearable sensors may be a user-friendly option to measure and objectively monitor the ROM. The objectives of our study were (1) to measure craniocervical flexion range of motion (ROM) associated with each stage of the CCFT using a wearable inertial sensor and to determine the reliability of the measurements and (2) to determine craniocervical flexion ROM targets associated with each stage of the CCFT to standardize their use for assessment and training of the deep cervical flexor (DCF) muscles.MethodsAdults from a university community able to successfully perform the CCFT participated in this study. Two independent examiners evaluated the CCFT in two separate sessions. During the CCFT, a small wireless inertial sensor was adhered to the centre of the forehead to provide real-time monitoring and to record craniocervical flexion ROM. The intra- and inter-rater reliability of the assessment of craniocervical ROM was calculated. This study was approved by the Research Ethics Committee of CEU San Pablo University (236/17/08).ResultsFifty-six participants (18 males, 23 females; mean [SD] age, 21.8 [3.45] years) were included in the study and successfully completed the study protocol. All interclass correlation coefficient (ICC) values indicated good or excellent reliability of the assessment of craniocervical ROM using a wearable inertial sensor. There was high variability between subjects on the amount of craniocervical ROM necessary to achieve each stage of the CCFT.ConclusionsThe use of inertial sensors is a reliable method to measure the craniocervical flexion ROM associated with the CCFT. The great variability in the ROM limits the possibility to standardize a set of targets of craniocervical flexion ROM equivalent to each of the pressure targets of the pressure biofeedback unit.
Highlights
The craniocervical flexion test (CCFT) is recommended when examining patients with neck pain related conditions and as a deep cervical retraining exercise option
The data corresponding to the range of motion (ROM) necessary to achieve each stage of the Craniocervical flexion test (CCFT) was expressed in degrees as means, standard deviation (SD), 95% confidence intervals (CIs) and as a percentage of the full range of the craniocervical flexion ROM
The descriptive data on the ROM and percentage of the full range showed a progressive increase of the amount of craniocervical flexion ROM necessary to achieve each stage of the CCFT (Table 1 and Fig. 3)
Summary
The craniocervical flexion test (CCFT) is recommended when examining patients with neck pain related conditions and as a deep cervical retraining exercise option. It has been reported that patients with neck pain, cervicogenic headache, temporomandibular disorders (TMDs) and craniofacial pain show alterations of their function and structure [12,13,14,15,16]. These muscles showed reduced electromyographic activity or delayed onset of activation [13,14,15,16,17,18,19,20]. The performance of the DCF muscles is frequently considered in the evaluation of patients with neck pain and related conditions [21, 22], as well as in the prescription of specific therapeutic exercise programmes [23]
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