Journal of Manipulative and Physiological Therapeutics
Original ArticleThe Relationship between Cervicogenic Headache and Impairment Determined by the Flexion-Rotation Test
Section snippets
Methods
In this observational study, the relationship between the presence and severity of CGH symptoms or associated factors and FRT mobility and examiner interpretation of the FRT was investigated. The Curtin University Human Research Ethics Committee approved this study. Written informed consent was obtained before the study commencement and subjects were able to withdraw at any time.
Results
Of 154 subjects screened for headache, 82 were rejected for the following reasons; 5 constant headache, 10 no associated neck pain, and 67 with diagnostic features of tension type headache or migraine. Accordingly, 72 subjects with CGH (20 males; mean age, 39 years; range, 21-66 years; SD, 12.8 years) and 20 without neck pain or CGH (age, 35 years; range, 22-61 years; SD, 9.2 years) were evaluated and completed this study.
The headache characteristics of the 72 headache subjects are presented in
Discussion
This is the first study to examine in subjects with CGH the relationship between the presence and severity of headache symptoms and the FRT. The study findings of a clear association between range of motion and headache severity, frequency, and duration, together with lack of association with other headache symptoms, and stability of the test in the presence of pain, will assist clinicians to refine and better interpret the FRT. Values recorded during the FRT were similar to previous reports
Conclusions
Subjects with CGH demonstrated an inverse relationship between an index of headache severity and range of motion measures taken during the FRT. Furthermore, headache frequency, intensity, and duration were the most significant predictors of range of motion measured by the FRT. Although the presence of headache during testing significantly reduces range during the FRT by 6°, it does not influence identification of a positive test. It does however suggest caution is warranted when using the FRT
Funding Sources and Potential Conflicts of Interest
No funding was used for this study. Three of the authors of this article (KB, KWR, TMH) provide postgraduate education for physiotherapists for which they receive a teaching fee.
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