Ogince Mark, Hall Toby, Robinson Kim, Blackmore A M
School of Physiotherapy, Curtin University of Technology, Noranda, Perth, WA, Australia.
Man Ther. 2007 Aug;12(3):256-62. doi: 10.1016/j.math.2006.06.016. Epub 2006 Nov 16.
This single-blind comparative group design aimed to investigate the sensitivity and specificity of the cervical flexion-rotation test in the diagnosis of C1/2-related cervicogenic headache. This study tested 23 cervicogenic headache, 23 asymptomatic controls and 12 migraine with aura subjects, all aged 18-66 years. In stage 1, an experienced manipulative physiotherapist who did not partake in the flexion-rotation test procedure identified C1/2 dysfunction using passive segmental mobility tests in the cervicogenic headache group. Those with C1/2 dysfunction participated in stage 2. In stage 2, using the flexion-rotation test, subjects were tested by two experienced manipulative physiotherapists blinded to the subjects' group allocation. Each therapist stated whether the test was positive or not based on the therapist's interpretation of range of motion. The sensitivity and specificity of the flexion-rotation test was 91% and 90%, respectively (P<.001), with an overall diagnostic accuracy of 91% (P<.001). The cervical flexion-rotation test significantly assists in the differential diagnosis of cervicogenic headache and in the identification of movement impairment at the C1/2 segment in patients with cervicogenic headache.
这种单盲比较组设计旨在研究颈椎屈伸旋转试验在诊断与C1/2相关的颈源性头痛中的敏感性和特异性。本研究对23例颈源性头痛患者、23例无症状对照者和12例伴有先兆的偏头痛患者进行了测试，所有受试者年龄在18至66岁之间。在第1阶段，一名未参与屈伸旋转试验程序的经验丰富的手法治疗师在颈源性头痛组中使用被动节段活动度测试来确定C1/2功能障碍。那些存在C1/2功能障碍的患者进入第2阶段。在第2阶段，使用屈伸旋转试验，由两名对受试者分组情况不知情的经验丰富的手法治疗师对受试者进行测试。每位治疗师根据对运动范围的判断来表明测试是否为阳性。屈伸旋转试验的敏感性和特异性分别为91%和90%（P<0.001），总体诊断准确率为91%（P<0.001）。颈椎屈伸旋转试验显著有助于颈源性头痛的鉴别诊断以及识别颈源性头痛患者C1/2节段的运动障碍。
