C0-C2 Axial Rotation Test
Purpose[edit | edit source]
The Flexion Rotation Test (FRT) is a valid and reliable measure of upper cervical mobility as it predominantly measures rotation between C1 and C2 vertebral level. However the test requires the subject to lie supine with the cervical and upper thoracic spine in complete flexion to localize rotation to the C1-C2 motion segment. Which can be painful for patients with lower cervical spine pain and dysfunction.
Technique[edit | edit source]
The patient is seated and the neck is placed in a neutral position. The therapist stabalizes the second cervical vertebra by fixing the C2 spinous process with their index finger and thumb. Thus, isolating movement to segmental levels above C2 . The head is then rotated passively by the therapist to the left and right.
MRI investigations found the normal value for C0-C2 axial rotation test in supine to be 22 degrees combined rotations to left and right.
The degree of rotation in the C0-C2 axial rotation test is much lower than the normal values for upper cervical rotation (C0-C2) combining left and right rotation ranges which is from 78 to 88°. It can be explained as during the C0-C2 axial rotation test, fixation of the C2 vertebra does not allow normal upper cervical movement to occur.
Evidence[edit | edit source]
A study conducted by Kiran Satpute et al, studying the correlation between the C0-C2 axial rotation test to the flexion rotation test in asymptomatic people, concluded that both tests have excellent intra- and inter-rater reliability in asymptomatic people and the range recorded during the FRT correlated highly with range recorded on the C0-C2 axial rotation test.
Another study also by Kiran Satpute et al, studying the correlation between the C0-C2 axial rotation test to the flexion rotation test in people with cervicogenic headache and migraine found also that there was a significant correlation between ROM recorded on the C0-C2 axial rotation test and the FRT. Also, that the C0-C2 axial rotation test demonstrated moderate to excellent reliability in people with CGH and episodic migraine.
References[edit | edit source]
- Satpute K, Nalband S, Hall T. The C0-C2 axial rotation test: normal values, intra-and inter-rater reliability and correlation with the flexion rotation test in normal subjects. Journal of Manual & Manipulative Therapy. 2019 Mar 15;27(2):92-8. BibTeXEndNoteRefManRefWorks
- Satpute KH, Parekh K, Hall TM. The C0–C2 axial rotation test–Reliability and correlation with the flexion rotation test in people with cervicogenic headache and migraine. Musculoskeletal Science and Practice. 2021 Feb 1;51:102286.