Craniocervical Flexion Test (CCFT) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing endurance/control of Deep Neck Flexors (Longus Colli/Capitis).
- Crucial for whiplash and cervicogenic headache.
How to Perform
- Setup: Patient supine with biofeedback cuff under neck (inflated to 20mmHg).
- Action: Patient performs a chin tuck (nod) to increase pressure to 22, 24, 26, 28, and 30mmHg, holding for 10s each.
Interpretation of Results
- Positive Test: Inability to hold pressure or use of superficial muscles (SCM/Platysma).
Clinical Context & Limitations
The Craniocervical Flexion Test (CCFT) should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Spine region, combining the Craniocervical Flexion Test (CCFT) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Jull, G. et al. (2008). Whiplash, Headache, and Neck Pain.
