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Cranial Cervical Flexion Test

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Other Names

  • CCFT
  • Cranio‐cervical Flexion Test
  • Craniocervical Flexion Test


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]


  • 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 5 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



  • Unknown

See Also


  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.
Created by:
John Kiel on 24 July 2019 00:04:26
Last edited:
15 May 2023 08:15:06