title: Performance of the craniocervical flexion test in subjects with and without chronic neck pain.
abstract: METHODS
  Cross-sectional comparative study.
  
  
  OBJECTIVE
  To compare the performance of the deep cervical flexor muscles on the craniocervical flexion test (CCFT) in individuals with and without neck pain.
  
  
  BACKGROUND
  Significant weakness of the superficial neck muscles is often found in patients with neck pain. However, there is scant work on deep cervical flexors performance in subjects with chronic nonspecific neck pain.
  
  
  METHODS
  Twenty asymptomatic subjects and 20 subjects with chronic neck pain (duration, > 3 months) were recruited. The CCFT was performed with the subject supine and required performing a gentle head-nodding action of craniocervical flexion (indicating yes) for 5 incremental stages of increasing difficulty. Each stage was held for 10 seconds, as guided by the pressure biofeedback unit. The data used for analysis were the highest pressure level that each subject was able to hold for 10 seconds, up to a maximum of 30 mmHg.
  
  
  RESULTS
  Reliability data obtained on 10 asymptomatic subjects indicated that the CCFT was reliable, with a kappa coefficient equal to 0.72. Subjects with chronic neck pain had significantly poorer (P < .001) performance on the CCFT (median pressure achieved, 24 mmHg) when compared with those in the asymptomatic group (median pressure achieved, 28 mmHg).
  
  
  CONCLUSIONS
  The results of this study demonstrated that patients with chronic neck pain had a poorer ability to perform the CCFT when compared with asymptomatic subjects. The study adds to the evidence that poor ability to perform the CCFT may be clinical evidence of an impairment that characterizes neck pain, regardless of origin.
authors.affiliation: Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong. rstchiu@polyu.edu.hk
authors.forename: Thomas Tai Wing
authors.initials: TT
authors.lastname: Chiu
authors.forename: Ellis Yuk Hung
authors.initials: EY
authors.lastname: Law
authors.forename: Tony Hiu Fai
authors.initials: TH
authors.lastname: Chiu
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005246:Feedback; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009334:Neck Muscles / Q000503:physiopathology*; D019547:Neck Pain; D012886:Skull / Q000503:physiopathology*; D013647:Task Performance and Analysis