Performance of the Craniocervical Flexion Test, Forward Head Posture, and Headache Clinical Parameters in Patients With Chronic Tension-Type Headache: A Pilot Study

Fernández‐de‐las‐Peñas, César; Pérez-de-Heredia, Marta; Molero-Sánchez, Alberto; Miangolarra‐Page, Juan Carlos

doi:10.2519/jospt.2007.2401

Cited by 77 publications

(65 citation statements)

References 36 publications

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“…36,50 Therefore, it is further possible that excessive activity of the sternocleidomastoid muscle during the CCFT induces TrP activation as previously suggested. 21,39,45 In fact, some studies have demonstrated that TrPs are associated with abnormal movement patterns 51 and increased motor neuron excitability 52 demonstrating the clinical relevance of TrPs in motor performance. In such scenario, manual therapies targeted to TrPs in the sternocleidomastoid muscle can restore the motor control performance of the CCFT.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Manual Treatment for Cervicogenic Headache and Active Trigger Point in the Sternocleidomastoid Muscle: A Pilot Randomized Clinical Trial

Bodes-Pardo¹,

Pecos‐Martín²,

Gallego‐Izquierdo³

et al. 2013

Journal of Manipulative and Physiological Therapeutics

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Section: Discussionmentioning

confidence: 98%

“…The CCFT is an indirect measure of deep cervical flexor muscle activation and strength, which has shown to be reliable. 39 …”

Section: Outcome Measuresmentioning

confidence: 97%

Manual Treatment for Cervicogenic Headache and Active Trigger Point in the Sternocleidomastoid Muscle: A Pilot Randomized Clinical Trial

Bodes-Pardo¹,

Pecos‐Martín²,

Gallego‐Izquierdo³

et al. 2013

Journal of Manipulative and Physiological Therapeutics

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“…Preliminary research on an asymptomatic population aged 18 to 68 years revealed no age or sex effects on test performance and determined a mean activation score of 7.6 ± 2.1 and a performance index of 65.8 ± 27.5, which showed between-day repeatability determined by the Intraclass Correlation Coefficient (ICC = .81 and .93 for the activation score and performance index respectively), 17,18 values which were later replicated by others. 19,20 Of clinical importance, studies of neck pain groups and single case studies using the original clinical test were showing that performance in patients with neck disorders was inferior with mean activation scores in the vicinity of 4 and performance indices of 10. 17,[19][20][21][22][23][24] Further Research and Development of the CCFT It was evident that quantifiable measures of muscle activity were required to establish the test's construct validity, that is, the CCFT tested predominantly and the activation of the deep cervical flexor muscles.…”

Section: The Craniocervical Flexion Testmentioning

confidence: 99%

Clinical Assessment of the Deep Cervical Flexor Muscles: The Craniocervical Flexion Test

Jull

O’Leary

Falla

2008

Journal of Manipulative and Physiological Therapeutics

381

313

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“…Although the CCFT is an indirect measure of deep cervical flexor muscle activation and strength, the validity 29,30 and reliability 16,32,51,52 of the CCFT have been established. Patients with type 2 whiplash-associated disorder or idiopathic neck pain have been found to be able to control 23 to 24 mmHg before pain or substitution occurs, 16,51 whereas asymptomatic individuals have been found to be able to control 28 to 30 mmHg for a 10-second hold.…”

Section: Outcome Measuresmentioning

confidence: 99%

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

Dunning¹,

Cleland²,

Waldrop³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

136

110

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A pproximately 54% of individuals have experienced neck pain within the last 6 months, 24 and the incidence of neck pain may be increasing. 76 The economic burden associated with the management of patients with neck pain is high, second only to low back pain in annual workers' compensation costs in the United States. 98Two recent clinical prediction rules 17,21,22,81 have been developed in an attempt to guide treatment selection for patients with neck pain. However, one has yet to be validated and only identifies those patients with neck pain likely to benefit from cervical traction, 81 and the other, which attempted to identify those patients with neck pain likely to benefit from thoracic manipulation and a general cervical range-of-motion (ROM) exer- T T METHODS:Patients completed the Neck Disability Index, the numeric pain rating scale, the flexion-rotation test for measurement of C1-2 passive rotation range of motion, and the craniocervical flexion test for measurement of deep cervical flexor motor performance. Following the baseline evaluation, patients were randomized to receive either HVLA thrust manipulation or nonthrust mobilization to the upper cervical (C1-2) and upper thoracic (T1-2) spines. Patients were reexamined 48-hours after the initial examination and again completed the outcome measures. The effects of treatment on disability, pain, C1-2 passive rotation range of motion, and motor performance of the deep cervical flexors were examined with a 2-by-2 mixed-model analysis of variance (ANOVA). T T RESULTS:One hundred seven patients satisfied the eligibility criteria, agreed to participate, and were randomized into the HVLA thrust manipulation (n = 56) and nonthrust mobilization (n = 51) groups. The 2-by-2 ANOVA demonstrated that patients with mechanical neck pain who received the combination of upper cervical and upper thoracic HVLA thrust manipulation experienced significantly (P<.001) greater reductions in disability (50.5%) and pain (58.5%) than those of the nonthrust mobilization group (12.8% and 12.6%, respectively) following treatment. In addition, the HVLA thrust manipulation group had significantly (P<.001) greater improvement in both passive C1-2 rotation range of motion and motor performance of the deep cervical flexor muscles as compared to the group that received nonthrust mobilization. The number needed to treat to avoid an unsuccessful outcome was 1.8 and 2.3 at 48-hour follow-up, using the global rating of change and Neck Disability Index cut scores, respectively. T T CONCLUSION:The combination of upper cervical and upper thoracic HVLA thrust manipulation is appreciably more effective in the short term than nonthrust mobilization in patients with mechanical neck pain. T T LEVEL OF EVIDENCE:Therapy, level 1b.

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Performance of the Craniocervical Flexion Test, Forward Head Posture, and Headache Clinical Parameters in Patients With Chronic Tension-Type Headache: A Pilot Study

Cited by 77 publications

References 36 publications

Manual Treatment for Cervicogenic Headache and Active Trigger Point in the Sternocleidomastoid Muscle: A Pilot Randomized Clinical Trial

Manual Treatment for Cervicogenic Headache and Active Trigger Point in the Sternocleidomastoid Muscle: A Pilot Randomized Clinical Trial

Clinical Assessment of the Deep Cervical Flexor Muscles: The Craniocervical Flexion Test

Upper Cervical and Upper Thoracic Thrust Manipulation Versus Nonthrust Mobilization in Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial

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