The C0–C2 axial rotation test – Reliability and correlation with the flexion rotation test in people with cervicogenic headache and migraine

Abstract

ObjectivesThe C0–C2 axial rotation test is a measure of upper cervical range of motion (UCROM), reported to be reliable in a headache free population. The objective was to determine the intra- and inter-rater reliability of the C0–C2 axial rotation test in people with a diagnosis of cervicogenic headache (CGH) or episodic migraine. MethodsTwo therapists independently evaluated UCROM during the C0–C2 axial rotation test and flexion-rotation test (FRT) with an iPhone in 70 subjects (mean age 37.7 SD 11.6 years) with a diagnosis of CGH (35 subjects) or episodic migraine (35 subjects) on two occasions. Measurement procedures were standardized; and the order of testing randomized. ResultsReliability of the C0–C2 axial rotation test was moderate to high (ICC > 0.70). The standard error of measurement and minimum detectable change for this test were at most 2°. In subjects with CGH mean UCROM to the most restricted side was 9.3° (1.9) and 8.8° (2.1) for rater 1 and 2 respectively. While in patients with episodic migraine mean UCROM to the restricted side was 13.7° (1.6) and 13.6° (2.0) for rater 1 and 2 respectively. DiscussionThe C0–C2 axial rotation test has at least moderate levels of reliability and correlates well with mobility determined by the FRT.