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Cranial Cervical Flexion Test

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The clinical application of the craniocervical flexion test. The patient is guided to each progressive pressure increment of the test by feedback from the pressure sensor. The clinician analyses the movement and detects the presence of any activity in the superficial flexors[1]
Illustration of Cranial Cervical Flexion Test[2]
  • CCFT
  • Cranio‐cervical Flexion Test
  • Craniocervical Flexion Test

Purpose

Description

  • The patient starts supine, neck in neutral position, hips and knees flexed into hooklying position
  • Blood pressure cuff is inflated to 20 mm Hg and is placed under the lordotic curve of the cervical spine
  • Keep the back of the head stable
  • The patient performs cranial cervical flexion in a graded fashion in 2 mm Hg increments (22, 24, 26, 28, and 30)
  • Each position is held for 10 seconds with 10 seconds rest between increments
  • Cranial cervical flexion is achieved with a head nod (as if saying 'yes') in the cervical region
  • The test is ended when the pressure decreases >20% or when substitution occurs during the head
  • Normal response is achieving 26-30 mm Hg

Pathology

Evidence

  • Unknown

See Also

References

  1. ↑ Jull, Gwendolen A., Shaun P. O'leary, and Deborah L. Falla. "Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test." Journal of manipulative and physiological therapeutics 31.7 (2008): 525-533.
  2. ↑ Peng, Baogan, et al. "Cervical proprioception impairment in neck pain-pathophysiology, clinical evaluation, and management: a narrative review." Pain and therapy 10.1 (2021): 143-164.
Created by:
John Kiel on 24 July 2019 00:04:26
Authors:
Last edited:
15 September 2025 02:22:29
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