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Cervical Flexion and Rotation Test for Cervicogenic Headache

The Cervical Flexion and Rotation Test (CF&RT) is a diagnostic procedure used to assess the presence of a cervicogenic headache. CF&RT involves the patient sitting upright while a physician applies pressure to their cervical vertebrae, gently flexing and rotating the head in order to determine the source of the headache and eliminate alternate causes. The physician palpates for areas of tenderness and pain and records any range of motion changes or muscular spasms associated with head movement

Transcript

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This is Brent of the Brookbush
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Institute, and in this video we're going to go
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over the cervical flexion and rotation test for cervicogenic headache. I'm
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going to have my friend Sonya come out, she's going to help me demonstrate. Now what
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we're trying to figure out, is Sonja's headache related to cervical dysfunction.
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This is pretty cool stuff, you should look up some of the research on
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cervicogenic headache, there's a good chance that physical therapy, athletic
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training, chiropractic could be a good resource for individuals who get certain
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types of headaches. Now the way we're going to test to see if Sonja's headache is
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cervicogenic in nature, is we're going to see if we can bring on her concordant
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signs, the signs that she came in complaining about, with a particular
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motion of her cervical spine, and that would be maximal flexion with maximal
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rotation; and what we're probably doing here is ligamentous lock of the
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cervical spine at the bottom. So we're tightening up all of these passive
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tissue structures so they can't move as much, and then rotating the upper-
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cervical spine, mostly C1 on C2 to see if that increased afferentation from our
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upper-cervical spine will bring on these cervicogenic headache symptoms;
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which if you get into the research on cervicogenic headaches, you'll start
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seeing that there's a lot about the upper-cervical spine and this
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nucleus called the cervical trigeminal nucleus that's up there that'll get a
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afferentation from all of this. Alright but the test itself, very simple,
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assess for symptoms in this position. If maximal flexion and rotation makes those
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symptoms worse or brings on symptoms then you know that cervicogenic
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headache is a possibility. The last thing to consider is more of a correlation and
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is worth investigating, which would be, okay she came in complaining about
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headache symptoms, when I did this test it didn't bring on her symptoms, but her
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range of motion was severely limited. In this case we're considering it
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a positive test, but only because we know she has headache and cervical
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dysfunction, which I think the being that
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physical-therapy, athletic training, chiropractice is such conservative treatment,
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I think it is worth exploring that we do some treatments and intervention on her
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neck, and see if we can reduce her headache symptoms anyway, even though the
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test itself didn't bring on concordant signs. So there you have it, maximal
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flexion, maximal rotation in both directions. Make sure you're assessing