Cranial Cervical Flexion Test

Cranial Cervical Flexion Test Purpose: Assess/train the endurance of the deep neck flexors using pressure biofeedback. Step 1: 0:14 With the patient lying in supine, fold the bladder of the biofeedback unit into thirds, and place it beneath the arch of the neck abutting the occiput. Inflate the stabilizer to a baseline of 20 mmHg. Do not allow the pressure of the cuff to push the neck into lordosis. Step 2: 0:49 Allow the patient to hold the gauge so that it can be viewed for feedback. Prop the patient’s elbow up using a towel roll so that they can keep the gauge within view without actively elevating the shoulder. Step 3: 1:12 Instruct the patient to perform a chin tuck and attempt to move the needle to the first incremental stage (22 mmHg). The patient can use their other hand to palpate their SCM and ensure that they are not cheating by using superficial muscles. Step 4: 1:36 Test the ability of the patient to hold each level for 10 seconds while demonstrating a proper movement pattern: - Without retraction of the cervical spine - Without use of superficial muscles - With a smooth, controlled motion Progress one 2 mmHg increment at a time. Step 5: 1:52 Train the patient at the highest achieved stage until sufficient endurance has been demonstrated to progress. Three to four 10-second holds with proper motor control should be demonstrated before progressing to the next level (up to 30 mmHg). Evidence: Leal and Dennison, 2011. ISC 21.1.3 pp. 19-20 Childs, 2008. A16-17