Purpose: To assess the ability of utilizing the deep neck flexors (rectus capitis anterior, rectus capitis lateralis, longus colli, longus capitis).
Test Position: Supine, hooklying.
Performing the Test: A blood pressure cuff is inflated to 20 mmHg and is placed between the lordotic curve and the surface of the table. While keeping the back of the head stable, the patient performs cranial cervical flexion in a graded fashion in 5 increments (22, 24, 26, 28, and 30 mmHg). Each position is held for 10 seconds with 10 seconds rest between increments. The cranial cervical flexion is performed by a head nod in the upper cervical spine. Make sure the patient’s jaw is relaxed, so that there is no platysma, hyoid muscle, or sternocleidomastoid recruitment. The test is ended when the pressure decreases >20% or when substitution occurs during the head nod. Normal response is achieving 26-30 mmHg.
Diagnostic Accuracy: Unknown.
Importance of the Test: Patients with forward head posture and neck pain have been found to have decreased activation and endurance of the deep cervical flexors (rectus capitis anterior, rectus capitis lateralis, longus colli, and longus capitis) - “Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test.” They tend to over-utilize other muscles (platysma, hyoid muscles, and especially the sternocleidomastoid) for postural maintenance, which leads to the commonly seen position of forward head postures-a position we commonly see in those who use computers frequently or engage in sedentary activity on a regular basis.
Note: tests should only be performed by a properly trained health care practitioner.