The relationship between cervicogenic headache and impairment determined by the flexion-rotation test.
OBJECTIVE
This study evaluates the association between probable cervicogenic headache (CGH) and associated headache symptoms and cervical spine impairment identified by the flexion-rotation test (FRT).


METHODS
This was an observational study. Ninety-two subjects were evaluated, 72 with probable CGH and 20 who were asymptomatic. 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 (ROM). Fifteen subjects reported headache during testing and were subsequently retested when pain-free. A paired t test was used to determine whether FRT mobility to the most restricted side differed when the subject was experiencing headache. Univariate linear regression analysis and multiple regression analysis were used to examine the relationship between subject and headache characteristics, and range of motion during the FRT. Logistic regression analysis was used to examine relationships between subject and headache characteristics and whether the FRT was positive or negative.


RESULTS
Mean ROM was significantly reduced (P < .01) by 6° in the presence of headache, but this did not influence test interpretation. Regression analysis revealed that half the variance in FRT ROM was explained by an index of headache severity or component parts but not by other headache characteristics.


CONCLUSIONS
These findings indicate a relationship between cervical movement impairment and the presence and severity of CGH.
School of Physiotherapy, Curtin Innovation Health Research Institute, Curtin University of Technology, Perth, Western Australia, Australia. halltm@netspace.net.au
Toby M
TM
Hall
Kathy
K
Briffa
Diana
D
Hopper
Kim W
KW
Robinson
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods*; D051298:Post-Traumatic Headache / Q000175:diagnosis*; D016059:Range of Motion, Articular / Q000502:physiology*; D012399:Rotation; D012680:Sensitivity and Specificity; D016037:Single-Blind Method