Main category | Test | Cut-off criteria | Treatment component |
---|---|---|---|
1. Reduced cervical flexibility | 1.1 Upper cervical | Â | Â |
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 | Â | Â | |
a) Flexion-extension | a) <17° | Lower cervical mobilization and ROM treatment and training | |
1.3 Upper and lower cervical | Â | Â | |
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) | Â | Â |
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 | Â | Â | |
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 | Â | Â | |
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 | Â | Â |
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 | Â | Â |
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 |