Seated cervical flexion-rotation test equivalent to supine for identifying cervical dysfunction in patients with dizziness/vertigo

BACKGROUND: The upper cervical spine should be assessed in patients with complaints of dizziness or vertigo [1–3]. The supine cervical flexion-rotation test (SupCFRT) reliably assesses for the presence of upper cervical spine dysfunction (UCSD) [4]. UCSD has been linked to symptoms often seen in those diagnosed with dizziness or vertigo. Patients diagnosed with dizziness/vertigo often do not tolerate the supine testing position necessary to perform the SupCFRT, but often tolerate sitting well. PURPOSE: To determine if UCSD can be assessed in sitting as reliably as in supine. METHODS: Forty-five college age students (23.7±3.3 years old) acted as controls while forty-six subjects (56.71±14.6 years old) who were referred for physical therapy services by their medical provider acted as the patient group. The SupCFRT was performed first, [4] the Seated Cervical Flexion-Rotation Test (SeatCFRT) was performed next by positioning the subjects seated with their back against a high-backed chair, the head was flexed maximally, then rotated maximally left and right. The SupCFRT [4] and SeatCFRT were considered positive if range of motion limitations were found. Results for each test was compared using McNamar X2. RESULTS: There was no difference, p > 0.05, between SupCFRT and SeatCFRT for all conditions; all subjects (n = 91), control subjects n = 45, subjects referred to physical therapy for treatment of dizziness or vertigo, n = 46. DISCUSSION: The SeatCFRT reliably identifies the presence of UCSD, in controls and patients diagnosed by a referring medical provider for dizziness or vertigo. Patients, who do not tolerate the supine position, can be evaluated for UCSD in the seated position.