Exercise prescription for Cervical spine Flashcards
Recall questionnaires to assess disability, psychology and nerve sensitivity
- NDI
- PSFS
- DASS 21
- PCS (catastrophizing)
- IES (PTSD)
- LANNS
- CSI
What to look for in neck assessment?
- Observation: posture, chin, scapula
- Balance
- Other joint screening
- C/sp ROM +/- OP/combined mvoements
- Neurological examination
Test based on triage
What are red flag pathologies
- CAD/VBI
- Tumour
- inflammatory diseases
What are tests for red flags/serious pathology?
- Cranial N tests
- VBI tests
- Other investigations/bloods
What are tests for radiculopathy/myelopathy?
- Neurological +/- MRI
What are the 4 categories that make up NSNP?
- Movement/articular impairment
- Motor impairment
- Sensori-motor
- Sensory/pain
What are tests for movement/articular impairments?
- ROM
- PAIVM
- PPIVM
What to assess for motor impairment?
- Axio-scapula
- Cervical Flexors
- Cervical extensors
What to assess for sensori-motor impairment?
- JPE
- SNPT
- Balance
What to test for for sensory/pain impairment?
- PPT
- CPT
- NTPT (ULTT)
Identify impairments that can cause
- Extension limit with pain
- increased headache
- Movement/articular: mechanical pain, joint immobility, UCS dysfunction
- Motor control: Poor MC of extensors
- Consider CGH
What does forward head posture indicate?
Impairment: Poor upper cervical motor control particularly in F/E
- consider daily movements
U/C mechanical articular impairment
What tests to use to assess upper cervical mechanical impairment?
AM +/- OP UCS
UCS PAIVM
What can downwardly rotated scapula indicate?
Poor axio scapular MC
What test to assess poor axio-scapula MC?
Scap hold
Scap repositioning
What can cause slight dizziness with flexion?
UCS mechanical imapirment?
JPE?
How to differentiate between articular/ MC
Supported and unsupported AM: if the same –> articular
What are static/dynamic tests for axioscapula control
- Scap position: tilt, protraction/retraction
- Forward head posture?
- Assess using most common daily activity - dynamic
What are tests for cervical flexors?
- Cranio-cervical flexion test
- Head lift test
How to assess for cervical extensors?
- Cervical extensor tests
- Cranio- cervical extensor test
- Extensor endurance
SEE tutorial demonstration for each
What are 4 indications for cervical flexor training?
- Poor active control of cervical flexion
- Active insufficiency
- poor performance on motor function tests
- Responds well to cervical flexor training
What are 4 indications for cervical extensor training?
- Poor active control of cervical extension
- Active insufficiency
- Patient performs poorly on motor function tests
- Patient responds positively to cervical extensor training
What are indications for axio-scapular training
- Active insufficiency
- Poor motor function tests
- DIscomfort with UL activities
- Responds well with scapula positioning
How to assess for cervical sensory motor impairment
- Joint position error: returning from flexor/extensor to neutral
- Smooth Pursuit neck torsion test:
