The C0–C2 axial rotation test – Reliability and correlation with the flexion rotation test in people with cervicogenic headache and migraine

• Published in: Musculoskeletal science & practice Vol. 51; no. NA; p. 102286
• Main Authors: Satpute, Kiran H., Parekh, Krisha, Hall, Toby M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2021
• Subjects: Cervicogenic headache; Flexion-rotation test; Migraine; Physical Medicine and Rehabilitation; The C0–C2 axial rotation test; Upper cervical spine; Flexion-rotation test; Cervicogenic headache; Upper cervical spine; Migraine; The C0–C2 axial rotation test
• ISSN: 2468-7812; 2468-8630; 2468-7812
• DOI: 10.1016/j.msksp.2020.102286

The C0–C2 axial rotation test is a measure of upper cervical range of motion (UCROM), reported to be reliable in a headache free population. The objective was to determine the intra- and inter-rater reliability of the C0–C2 axial rotation test in people with a diagnosis of cervicogenic headache (CGH) or episodic migraine. Two therapists independently evaluated UCROM during the C0–C2 axial rotation test and flexion-rotation test (FRT) with an iPhone in 70 subjects (mean age 37.7 SD 11.6 years) with a diagnosis of CGH (35 subjects) or episodic migraine (35 subjects) on two occasions. Measurement procedures were standardized; and the order of testing randomized. Reliability of the C0–C2 axial rotation test was moderate to high (ICC > 0.70). The standard error of measurement and minimum detectable change for this test were at most 2°. In subjects with CGH mean UCROM to the most restricted side was 9.3° (1.9) and 8.8° (2.1) for rater 1 and 2 respectively. While in patients with episodic migraine mean UCROM to the restricted side was 13.7° (1.6) and 13.6° (2.0) for rater 1 and 2 respectively. The C0–C2 axial rotation test has at least moderate levels of reliability and correlates well with mobility determined by the FRT. •The reliability of the C0–C2 axial rotation test is moderate to high.•This test has a moderate to good correlation with the flexion rotation test.•Both tests identify restriction of UCROM in cervicogenic headache.•UCROM is more restricted in people with CGH than those with episodic migraine.