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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]