The diagnostic validity of the cervical side bend-rotation test for C 1/2 dysfunction

Area of Science:

• Orthopedics
• Neurology
• Diagnostic Medicine

Background:

• Neck pain and headaches are highly prevalent, affecting up to 66% of individuals.
• Upper cervical segmental dysfunction is frequently linked to neck pain and various headache types.
• Clinical assessment tools like the flexion-rotation test (FRT) and side bend-rotation test (SBRT) are used to evaluate upper cervical joint function.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the side bend-rotation test (SBRT) for detecting C1-2 joint dysfunction.
• To compare the SBRT's validity against established tests like the FRT and joint play assessment.

Main Methods:

• A prospective diagnostic accuracy study was conducted within a case-control framework.
• Participants included individuals with medically diagnosed sinus headaches and a control group.
• The SBRT, FRT, and C1-2 joint play assessments were performed on all participants.

Main Results:

• The SBRT demonstrated 100% sensitivity and 62% specificity in detecting C1-2 hypomobility using a cutoff score of <25°.
• A total of 80 individuals were analyzed, with mean SBRT range of motion (ROM) of 31.4° ± 9.4°.
• ROC curve analysis confirmed the <25° cutoff for the SBRT.

Conclusions:

• The SBRT, with a cutoff of ≤25°, is a highly sensitive test for identifying C1-2 dysfunction.
• Scores above 25° on the SBRT may effectively rule out C1-2 dysfunction.
• The SBRT can be a valuable component in the clinical assessment of C1-2 dysfunction, though further research is needed.