Deep Cervical Flexor Endurance Test

The Deep Cervical Flexor Endurance Test is a measure of the ability of deep neck flexor muscles to maintain a vital stabilizing force at the cervical spine. It involves having the patient maintain a fixed head position for a set amount of time, and the time that this is held for is used as an indication of the endurance of the deep neck flexors. This test is typically performed on athletes to help determine their functional strength in the neck and shoulder area, as well as their readiness

Transcript

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This is Brent of the Brookbush
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...blank
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Institute, in this video I'm going to bring
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you the deep cervical flexor endurance
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test. Now I use this test in my
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assessments to replace those manual
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muscle tests we would do for under
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active structures, and those with
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cervical dysfunction. I think you'll find
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the traditional manual muscle tests
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focus on muscles that we presume, or
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theorized to become overactive or
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synergistically dominant in those with
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movement impairment and cervical
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dysfunction. So I have my friend Melissa
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come out, she's going to help me
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demonstrate this test, which is quite a
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challenging test. It is a test we have a
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lot of research on, it's fairly well
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standardized. Notice that Melissa starts
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in a hook lying prone position, so her
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legs aren't straight, and her hands are
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on her stomach which is going to help
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standardize the position of her
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shoulders and scapula. From here what I
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want to do is I want to tuck Melissa's
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chin, and then I'm going to raise her
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head off the table two and a half
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centimeters, and the way I'm going to
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standardize that is it's going to be the
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width of my index and third finger,
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second and third finger, just behind the
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most posterior portion of her occiput,
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and so she can just go ahead and relax
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there for a second. Now what I'm going to
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do from here is cue her to tuck her
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chin as far as she can, and lift her head
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up just far enough so she can feel, but
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not squish my fingers. And once she's
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there, go ahead relax for a second, once
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she's there I'm going to time her and look
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for one of the few dysfunctions to
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happen. Once those dysfunctions happen of
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course the time is over. Those very few
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dysfunctions are does she lose her chin
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tuck, and the way I can tell by that is
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does she lose these lines right here,
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this is the double chin test. I think
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you'll find that your clients hate this
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test because it makes them do a double
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chin, that's what she has, these lines
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here. If she loses those I know she lost
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a chin tuck. If when she raises her head
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she then loses that head elevation, right
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loses that flexion of the cervical
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spine and
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crushes my fingers, test over. If she
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does the opposite, so I have her in this
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chin tucked position and she starts
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going into that forward head, good sign
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that she's very synergistically dominant
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in these muscles here, then I then the
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test is over. So we got those three signs
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right off the bat, and a fourth sign
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being she just doesn't want to continue
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with the test. Maybe she feels fatigued
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and and she she just doesn't like how it
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makes her neck feel, that's also the end
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of the test. So there's four standardized
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signs: we got the loss of these lines in
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the chin tuck, increase of pressure on my
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fingers, decrease in pressure on my
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fingers, or her not wanting to go further
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with the test, that would be the end of
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the time. The other thing we can do that
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is not standardized, is get a little
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additional information for my manual
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therapists out there is have her chin
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tuck, have a raise her head into flexion
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here, just just barely off my finger so
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she can just feel it, and I can use my
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other hand to palpate some of these
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muscles. We do have good research that
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shows the sternocleidomastoid is often
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very overactive in those with cervical
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dysfunction. We could try to palpate the
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scalenes, here are her anterior and
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middle scalenes very overactive. What
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about our levator scapulae, this might
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just give us a little additional
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information on some stuff we can do
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during our mobility portion, or release
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portion of our intervention to help with
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cervical function, before we start doing
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these deep cervical flexor activation
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exercises. Now you got those signs, how
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long should she be able to hold this
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perfectly? Minimum of 30 seconds. If we're
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just going to build some general
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guidelines less than 30 seconds, I'm
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definitely going to call weak regardless
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of what the population is. Less than 30
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seconds the individual needs to work on
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their deep cervical flexor endurance. 30
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to 60 seconds, probably sufficient for a
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normal not active fairly sedentary
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population.
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So maybe that's our first goal is just
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to get to 30 to 60 seconds. 60 seconds
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plus very good for a sedentary
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population, but probably insufficient for
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an active population who may need to go
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90 seconds, maybe even two minutes. You
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think of the amount of force that's put
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on somebody's cervical spine during
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sporting activity in the fact that a
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play generally lasts longer than 60 to
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90 seconds, we're going to need to take
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them a little longer. So take you guys
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through this test, you're going to go
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flexion and then up on the fingers, have
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Melissa raise her head keeping that chin
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tuck, I'm monitoring chin tuck, finger
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pressure. Melissa's already lost pressure,
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that would be the end of the test at
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roughly 10 seconds, as I monitor the
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clock behind me. There you guys go,
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another test you can add to your arsenal.
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You're going to probably want to start
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with a postural or movement assessment,
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then move on to these more specific
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assessments to see if isolated
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activation techniques are necessary. I
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hope you guys enjoy using this test and
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it refined your intervention, so that you
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guys can decrease dysfunction and
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improve performance. Thank you.