Comparative analysis and diagnostic accuracy of the cervical flexion–rotation test

The Journal of Headache and Pain

Original

Diana Hopper¹  Kim Robinson¹  Toby M. Hall¹  Kathy Briffa¹ 

[1] School of Physiotherapy, Curtin Innovation Health Research Institute, Curtin University of Technology, Bentley, Perth, Western Australia;

关键词: Cervicogenic headache;    Migraine;    Neck;    Sensitivity and specificity;    Range of motion;   

DOI  :  10.1007/s10194-010-0222-3

 received in 2010-03-15, accepted in 2010-04-26,  发布年份 2010

来源: Springer

【 摘 要 】

The aim of this study was to compare the findings of the cervical flexion–rotation test (FRT) between subjects with probable cervicogenic headache (CGH), migraine without aura (Migraine), and multiple headache forms (MHF). An additional aim was to identify the diagnostic accuracy of the FRT in CGH evaluation. Sixty subjects were evaluated: 20 with CGH, 20 with Migraine, and 20 with MHF. Subject and headache symptoms were evaluated by questionnaire. A single-blind examiner conducted the FRT, reporting the test state (positive or negative) before measuring range of motion using a goniometer. The average range of unilateral rotation to the most restricted side was 25°, 42° and 35° for groups CGH, Migraine and MHF, respectively. The difference between groups was significant (P < 0.001). Range of rotation was significantly reduced in the CGH group when compared to groups Migraine (P < 0.001) and MHF (P = 0.001), with an additional smaller significant difference between groups Migraine and MHF (P = 0.039). A receiver operating curve revealed that an experienced examiner using the FRT was able to make the correct diagnosis 85% of the time (P < 0.001), with a positive cut-off value of 30°. Multivariate regression analysis revealed that 44% of the variance in FRT range of motion was explained by the presence of two variables: neck movement or positions provoke headache, and neck symptoms precede headache, but not by other factors associated with migraine. These findings provide further evidence supporting the clinical utility of the FRT in CGH evaluation.

【 授权许可】

Unknown   
© Springer-Verlag 2010