Performance of the craniocervical flexion test in subjects with and without chronic neck pain

Study Design: Cross-sectional comparative study.Objective: To compare the performance of the deep cervical flexor muscles on the craniocervical flexion test (CCFT) in individuals with and without neck pain.Background: Significant weakness of the superficial neck muscles is often found in patients with neck pain. However, there is scant work on deep cervical flexors performance in subjects with chronic nonspecific neck pain.Methods and Measures: Twenty asymptomatic subjects and 20 subjects with chronic neck pain (duration, >3 months) were recruited. The CCFT was performed with the subject supine and required performing a gentle head-nodding action of craniocervical flexion (indicating yes) for 5 incremental stages of increasing difficulty. Each stage was held for 10 seconds, as guided by the pressure biofeedback unit. The data used for analysis were the highest pressure level that each subject was able to hold for 10 seconds, up to a maximum of 30 mmHg.Results: Reliability data obtained on 10 asymptomatic subjects indicated that the CCFT was reliable, with a kappa coefficient equal to 0.72. Subjects with chronic neck pain had significantly poorer (P