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Cervical Flexion-Rotation Test

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Other Names

  • CFRT
  • Flexion-Rotation Test


Demonstration of the cervical flexion-rotation test[1]
  • To assess the mobility of the C1-C2 cervical vertebrae
  • C1-C2 motion segment accounts for 50% of the rotation in the cervical spine


  • The patient is supine, examiner is at the head of the bed
  • Occiput is maximally flexed, ideally resting against the examiners abdomen
  • The patients head is then maximally rotated to the left and the right
  • A positive test includes:
    • Firm resistance is encountered
    • Pain is provoked
    • Range is limited before the expected end range


  • Decreased mobility of the C1-C2 joint


  • Sensitivity: 90%[2]
  • Specificity: 88%
  • 92% agreement for experienced examiners

See Also


  1. Page, Phil. "Cervicogenic headaches: an evidence-led approach to clinical management." International journal of sports physical therapy 6.3 (2011): 254.
  2. Hall TM, Robinson KW, AkasakaK. Intertester Reliability and Diagnostic Validity of the Cervical Flexion-Rotation Test. J Manipulative Physiol Ther. 2008;31:293-300
Created by:
John Kiel on 23 July 2019 22:18:24
Last edited:
25 March 2023 07:52:05