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Table 1 Decision model of treatment for selection of tailored treatment (for details, see Table 2 in Björklund et al [21])

From: Is tailored treatment superior to non-tailored treatment for pain and disability in women with non-specific neck pain? A randomized controlled trial

Main category

Test

Cut-off criteria

Treatment component

1. Reduced cervical flexibility

1.1 Upper cervical

  

a) Flexion-extension

a) < 68°

Upper cervical mobilization and ROM treatment and training

b) Passive rotation in max flexion

b) <32°

Qualifier: a) or b)

1.2 Lower cervical

  

a) Flexion-extension

a) <17°

Lower cervical mobilization and ROM treatment and training

1.3 Upper and lower cervical

  

a) Axial rotation

a) <109°

Upper and lower mobilization and ROM treatment and training

2. Impaired cervical muscle strength-endurance and functional strength

2.1 Cranio-cervical flexion (CCF)

  

a) Maximal voluntary contraction (MVC)

a) < 2.5 Nm

CCF-exercises

b) Endurance (50 % MVC)

b) < 20 s

Qualifier: a) or b)

2.2 Cervico-thoracic

  

a) Flexion MVC

a) < 40 N

Strength training cervico-thoracic muscles

b) Extension MVC

b) < 140 N

Qualifier: a) or b)

2.3 Lifting ability

  

a) C-PILE

a) < 0.12 kg/kga

Strength training of shoulder-arm muscles

b) Subjective ability to carry and lift

b) ≥ 4 on the scale 1-6…how do you manage to carry/lift?

1 = very good; 6 = very bad [51]

Qualifier: a) and b)

3. Impaired sensor-motor control

3.1 Symptoms and activity limitations

Combinations of dizziness, balance disturbances, headache and difficulties to rotate the head [51].

Cervical repositioning/movement control, oculomotor exercises

3.2 Peak speed of cervical axial rotation

<170°/s

Peak speed training in cervical axial rotation

4. Trapezius myalgia

4.0

  

a) Physiotherapy assessment

a) Criteria according to Ohlsson and coworkers [26] with amendments [25]

EMG-biofeedback training, a progressive program with 8 standardized exercises

b) PPT upper trapezius muscles

b) < 175 kPa right; < 168 kPa left

Qualifier: a) and b)

5. Cervicogenic headache

5.0

  

a) Physiotherapy assessment

a) Criteria of the Cervicogenic Headache International Study Group [72] with amendment of reduced ROM for upper cervical and palpable upper cervical joint dysfunction [73]

Mobilization of upper cervical, CCF-exercise, endurance training for scapular muscles, postural correction

b) Range of motion

  1. ROM range of motion, Nm newton meter, Sec seconds, N newton, C-Pile cervical progressive isoinertal lifting evaluation test, PPT pressure pain threshold, kPa kilopascal, EMG electromyography
  2. amaximal lifted weight/adjusted body weight [74]