You can only view 3 videos without an account. Become a Member to access all videos on the website.
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
00:00:0400:00:06
This is Brent of the Brookbush
00:00:0400:00:06
...blank
00:00:0600:00:07
Institute, in this video I'm going to bring
00:00:0700:00:09
you the deep cervical flexor endurance
00:00:0900:00:11
test. Now I use this test in my
00:00:1100:00:14
assessments to replace those manual
00:00:1400:00:16
muscle tests we would do for under
00:00:1600:00:17
active structures, and those with
00:00:1700:00:19
cervical dysfunction. I think you'll find
00:00:1900:00:21
the traditional manual muscle tests
00:00:2100:00:24
focus on muscles that we presume, or
00:00:2400:00:27
theorized to become overactive or
00:00:2700:00:29
synergistically dominant in those with
00:00:2900:00:31
movement impairment and cervical
00:00:3100:00:33
dysfunction. So I have my friend Melissa
00:00:3300:00:34
come out, she's going to help me
00:00:3400:00:38
demonstrate this test, which is quite a
00:00:3800:00:40
challenging test. It is a test we have a
00:00:4000:00:42
lot of research on, it's fairly well
00:00:4200:00:45
standardized. Notice that Melissa starts
00:00:4500:00:48
in a hook lying prone position, so her
00:00:4800:00:49
legs aren't straight, and her hands are
00:00:4900:00:51
on her stomach which is going to help
00:00:5100:00:53
standardize the position of her
00:00:5300:00:56
shoulders and scapula. From here what I
00:00:5600:00:59
want to do is I want to tuck Melissa's
00:00:5900:01:02
chin, and then I'm going to raise her
00:01:0200:01:04
head off the table two and a half
00:01:0400:01:06
centimeters, and the way I'm going to
00:01:0600:01:08
standardize that is it's going to be the
00:01:0800:01:10
width of my index and third finger,
00:01:1000:01:13
second and third finger, just behind the
00:01:1300:01:16
most posterior portion of her occiput,
00:01:1600:01:18
and so she can just go ahead and relax
00:01:1800:01:21
there for a second. Now what I'm going to
00:01:2100:01:22
do from here is cue her to tuck her
00:01:2200:01:25
chin as far as she can, and lift her head
00:01:2500:01:29
up just far enough so she can feel, but
00:01:2900:01:34
not squish my fingers. And once she's
00:01:3400:01:37
there, go ahead relax for a second, once
00:01:3700:01:40
she's there I'm going to time her and look
00:01:4000:01:42
for one of the few dysfunctions to
00:01:4200:01:45
happen. Once those dysfunctions happen of
00:01:4500:01:47
course the time is over. Those very few
00:01:4700:01:50
dysfunctions are does she lose her chin
00:01:5000:01:52
tuck, and the way I can tell by that is
00:01:5200:01:54
does she lose these lines right here,
00:01:5400:01:57
this is the double chin test. I think
00:01:5700:01:59
you'll find that your clients hate this
00:01:5900:02:01
test because it makes them do a double
00:02:0100:02:03
chin, that's what she has, these lines
00:02:0300:02:05
here. If she loses those I know she lost
00:02:0500:02:08
a chin tuck. If when she raises her head
00:02:0800:02:13
she then loses that head elevation, right
00:02:1300:02:15
loses that flexion of the cervical
00:02:1500:02:17
spine and
00:02:1700:02:21
crushes my fingers, test over. If she
00:02:2100:02:24
does the opposite, so I have her in this
00:02:2400:02:26
chin tucked position and she starts
00:02:2600:02:29
going into that forward head, good sign
00:02:2900:02:31
that she's very synergistically dominant
00:02:3100:02:35
in these muscles here, then I then the
00:02:3500:02:38
test is over. So we got those three signs
00:02:3800:02:40
right off the bat, and a fourth sign
00:02:4000:02:42
being she just doesn't want to continue
00:02:4200:02:44
with the test. Maybe she feels fatigued
00:02:4400:02:48
and and she she just doesn't like how it
00:02:4800:02:50
makes her neck feel, that's also the end
00:02:5000:02:53
of the test. So there's four standardized
00:02:5300:02:55
signs: we got the loss of these lines in
00:02:5500:02:58
the chin tuck, increase of pressure on my
00:02:5800:03:01
fingers, decrease in pressure on my
00:03:0100:03:04
fingers, or her not wanting to go further
00:03:0400:03:07
with the test, that would be the end of
00:03:0700:03:09
the time. The other thing we can do that
00:03:0900:03:14
is not standardized, is get a little
00:03:1400:03:17
additional information for my manual
00:03:1700:03:19
therapists out there is have her chin
00:03:1900:03:22
tuck, have a raise her head into flexion
00:03:2200:03:24
here, just just barely off my finger so
00:03:2400:03:26
she can just feel it, and I can use my
00:03:2600:03:28
other hand to palpate some of these
00:03:2800:03:30
muscles. We do have good research that
00:03:3000:03:33
shows the sternocleidomastoid is often
00:03:3300:03:34
very overactive in those with cervical
00:03:3400:03:36
dysfunction. We could try to palpate the
00:03:3600:03:39
scalenes, here are her anterior and
00:03:3900:03:41
middle scalenes very overactive. What
00:03:4100:03:43
about our levator scapulae, this might
00:03:4300:03:44
just give us a little additional
00:03:4400:03:46
information on some stuff we can do
00:03:4600:03:50
during our mobility portion, or release
00:03:5000:03:54
portion of our intervention to help with
00:03:5400:03:56
cervical function, before we start doing
00:03:5600:03:58
these deep cervical flexor activation
00:03:5800:04:03
exercises. Now you got those signs, how
00:04:0300:04:04
long should she be able to hold this
00:04:0400:04:08
perfectly? Minimum of 30 seconds. If we're
00:04:0800:04:10
just going to build some general
00:04:1000:04:11
guidelines less than 30 seconds, I'm
00:04:1100:04:14
definitely going to call weak regardless
00:04:1400:04:16
of what the population is. Less than 30
00:04:1600:04:18
seconds the individual needs to work on
00:04:1800:04:21
their deep cervical flexor endurance. 30
00:04:2100:04:25
to 60 seconds, probably sufficient for a
00:04:2500:04:28
normal not active fairly sedentary
00:04:2800:04:30
population.
00:04:3000:04:32
So maybe that's our first goal is just
00:04:3200:04:36
to get to 30 to 60 seconds. 60 seconds
00:04:3600:04:40
plus very good for a sedentary
00:04:4000:04:44
population, but probably insufficient for
00:04:4400:04:46
an active population who may need to go
00:04:4600:04:49
90 seconds, maybe even two minutes. You
00:04:4900:04:52
think of the amount of force that's put
00:04:5200:04:54
on somebody's cervical spine during
00:04:5400:04:56
sporting activity in the fact that a
00:04:5600:04:58
play generally lasts longer than 60 to
00:04:5800:05:00
90 seconds, we're going to need to take
00:05:0000:05:03
them a little longer. So take you guys
00:05:0300:05:05
through this test, you're going to go
00:05:0500:05:10
flexion and then up on the fingers, have
00:05:1000:05:13
Melissa raise her head keeping that chin
00:05:1300:05:15
tuck, I'm monitoring chin tuck, finger
00:05:1500:05:19
pressure. Melissa's already lost pressure,
00:05:1900:05:21
that would be the end of the test at
00:05:2100:05:25
roughly 10 seconds, as I monitor the
00:05:2500:05:27
clock behind me. There you guys go,
00:05:2700:05:30
another test you can add to your arsenal.
00:05:3000:05:32
You're going to probably want to start
00:05:3200:05:34
with a postural or movement assessment,
00:05:3400:05:36
then move on to these more specific
00:05:3600:05:38
assessments to see if isolated
00:05:3800:05:41
activation techniques are necessary. I
00:05:4100:05:44
hope you guys enjoy using this test and
00:05:4400:05:46
it refined your intervention, so that you
00:05:4600:05:48
guys can decrease dysfunction and
00:05:4800:05:51
improve performance. Thank you.
Related Videos
Tibial Internal Rotator Manual Muscle Testing (MMT) for an Active Population
Posterior Tibialis Manual Muscle Testing (MMT) for an Active Population
Shoulder External Rotator Manual Muscle Testing (MMT) for an Active Population
Gluteus Maximus Manual Muscle Testing (MMT) for an Active Population
Deep Cervical Flexor Endurance Test
Femoral Nerve Neurodynamic Tests
Lumbar Movement Assessment
Slump Test
Upper Body Movement Assessment
Straight Leg Raise Test and Well Leg Raise Test