Functional cervical strength test (Full Version)

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buckeye -> Functional cervical strength test (June 22, 2007 3:46:00 AM)

Hello Forum,

What tests do you use for functional cervical strength/muscle performance?



physioo -> Re: Functional cervical strength test (June 22, 2007 7:47:00 AM)

good 1
anyone can help?



alodato -> Re: Functional cervical strength test (June 22, 2007 9:03:00 AM)

Retract the neck into neutral or correct posture and have the patient swallow. If they can't swallow without their head going into protraction, then they are weak in their anterior stabilizers



ragempt -> Re: Functional cervical strength test (June 22, 2007 10:58:00 AM)

awsome post

alodato, whats your source? thats a really cool quick test.



alodato -> Re: Functional cervical strength test (June 22, 2007 11:51:00 AM)

It was taught to me by Erl Petman in a NAIOMT course



jma -> Re: Functional cervical strength test (June 22, 2007 3:41:00 PM)

Definitely a good measure to remember.



physioo -> Re: Functional cervical strength test (June 23, 2007 7:32:00 AM)

nice one!
and how would you strengthen the ant stabilizerS?



jma -> Re: Functional cervical strength test (June 24, 2007 2:44:00 AM)

I would think isometric chin tucks on a towel roll.



bonmar -> Re: Functional cervical strength test (June 24, 2007 8:57:00 AM)

I was taught (I believe(?) it was in one of Stanley Paris' courses) that you lie supine, axial extend, and lift your head off the plinth. One should work on repeating 10 reps of 3-4 sets/day.

The progression I use is 1)sitting axial extension 2) isometric cervical flexion (while in axial extension) 3)"chin tucks" supine, and 4)lifting the head while in axial extension.



physioo -> Re: Functional cervical strength test (June 24, 2007 10:55:00 AM)

when u say axial extension
is this a fancy word for retraction..
pls elabaorate
thanks



bonmar -> RE: Re: Functional cervical strength test (July 2, 2007 12:18:17 PM)

Yes, axial extension would be retraction.



alodato -> RE: Re: Functional cervical strength test (July 2, 2007 4:44:40 PM)

Strengthening ant stabilizers (or how it was taught to me) in a 3 step progression:

1.  Have the patient lie supine on a table, put the back of their head on a towel roll making sure their chin height is even with their forehead.  Have the do short neck flexion (chin to throat) while making sure they minimize their use of SCM.

2.  Same postition as above, have the patient do short neck flexion and then imagine they are pulling their chin twds their sternal notch without their head lifting off the towel roll

3.  Same position as previous two, have pt. do short neck flexion and while maintaining short neck flexion they pull their chin twds their heart (they can lift the back of their head off the towel roll) while maintaining short neck flexion all the way through the movement.



buckeye -> RE: Re: Functional cervical strength test (July 3, 2007 9:30:09 AM)

Great ideas. Thanks for the replies. I have used the head lift time as a measure of fucntional strength but was not aware if there was a standard hold time that could be considered "functional." I have generally used 30 seconds as a standard

I use the head lift exercise in all four directions for strengthening. The supine is most difficult to teach to avoid protrusion and SCM activity. I like alodato's method.
Since the neck muscles are largely postural and tonic, I use prolonged hold times and keep repetitions low for strengthening. Overall goal for most patients is to hold the head off the plinthe/towel for 30-60 seconds. But the starting may be only five counts.
Often, I will have the patient attempt a total hold time of 30-60 seconds per set with multiple reps initially then gradually decrease reps as hold time increases (so total hold time is still at about 30-60 seconds).



rwillcott -> RE: Re: Functional cervical strength test (July 6, 2007 7:20:28 PM)

I also use all of the neck retraction exercises mentioned above.  But lets not forget that the neck requires stability during movements such as rotation etc.  When we treat the knee often times we begin in supine with simple isometric exercies (quad setting) and progress to functional activities such as step-downs.  Why is the neck different when it comes to exercise prescription. 

A course instructor once told us a story of an MVA patient with chronic neck pain that was sent to him by another PT since there had been no improvement.  The patient had been performing isometirc neck exercises in sitting.  He had the patient stop performing these exercises and taught her how to recruir the DNF's.  He also progressed to a chin nod with rotation against resistance.  Within a short time the patient was pain free!

Try placing a stabilizing strap around the patients head and tie a piece of yellow tubing to it.  Have them perform a chin nod and turn their head against resistance in a slow and controlled movement.  Your now recruiting the DNF's during a functional movement.

Great topic!



jwb -> RE: Functional cervical strength test (July 7, 2007 2:21:01 AM)

As your final progression, try neck ROM while pressing a physioball against a wall.  Make sure the patient maintains good posture.  Patients will hate it, but it works the neck very well. Even try a weighted plyoball if the physioball is to easy.  



blast7 -> RE: Functional cervical strength test (July 27, 2007 5:36:22 PM)

Reason for test: Neck flexor muscle endurance has been negatively correlated with cervical pain and dysfunction.

Test:The neck flexor muscle endurance test used in this study was performed in a supine, hook-lying position and was operationally defined as follows: with the chin maximally retracted and maintained isometrically, the subject lifted the head and neck until the head was approximately 2.5 cm (1 in) above the plinth while keeping the chin retracted to the chest (Fig. 1). Once in position, a line was drawn across 2 approximated skin folds along the subject's neck, and the rater placed his or her left hand on the table just below the occipital bone of the subject's head (Fig. 2). Verbal commands (ie, "Tuck your chin" or "Hold your head up") were given when either the line edges began to separate or the subject's head touched the rater's left hand. The test was terminated if the edges of the lines no longer approximated each other due to loss of chin tuck or the subject's head touched the rater's hand for more than 1 second. To our knowledge, this operational definition has not been used before.
Source:
Reliability of a Measurement of Neck Flexor Muscle Endurance
Kevin D Harris, Darren M Heer, Tanja C Roy, Diane M Santos, Julie M Whitman and Robert S Wainner



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