Neck Pain w/ Movement Coordination Impairments (WAD)

Question 1

Clinical Presentation

Answer 1

• Associated (referred) shoulder girdle or UE pain
• Associated varied non-specific concussive signs and symptoms
• Dizziness/Nausea
• Headache, concentration, or memory difficulties (confusion, hypersensitivity to stimuli)

Question 2

Tests & Measures

Answer 2

• Cervical ROM
• Cranio-Cervical Flexion Test (CCFT)
• Neck Flexor/Extensor muscle endurance tests
• Scapular retraction depression test
• Cervical Proprioception test
• Joint position error (JPE)
• Cervical Musculature palpation

Question 3

Exam Findings

Answer 3

• (+) Cranial cervical flexion test (CCFT)
• (+) Neck flexor muscle endurance test
• (+) Pressure algometry
• Strength and Endurance deficits of the neck muscles
• Point tenderness may include myofascial trigger points
• Sensorimotor impairment may include altered muscle activation patterns, proprioceptive deficit, postural balance or control
• Neck and referred pain reproduced by provocation of the involved cervical segments

Question 4

Interventions

Answer 4

• Upglide/Downglide
• Supine cervical passive physiological rotation mobilization
• Cervical flexion rotation AA rotation hold-relax technique
• Supine OA Flexion/Extension hold relax
• Supine craniocervical A-P mobilizations
• Supine gentle distraction manual traction
• STM (cervical paraspinals, upper trap, levator scap)
• PNF contract-relax (cervical paraspinals, upper trap, levator scap)

Question 5

Exercise

Answer 5

• Graded exposure cervical AROM
• Levator, upper trap, cervical paraspinals stretch
• Deep cervical muscle training (quadruped)
• Proprioceptive
• Combined Exercise: active cervical ROM and isometric low-load strengthening