• ​​Testing for

Ischemia or Circulation deficiency of the vertebral artery at the transverse foramen.

• Test positioning

The client lies supine with their head extending past the end of the table, and the therapist sits with both hands supporting the client's head.

• Action

Slowly extend, rotate, and laterally flex the client's cervical spine to each side.

Then observe the client for dizziness, blurred vision, nystagmus, slurred speech, or loss of consciousness.

Each position should be held for approximately 30 seconds.

• Positive finding

Dizziness, blurred vision, nystagmus, slurred speech, or loss of consciousness are indicative of partial or complete occlusion of the vertebral artery.

• Special considerations & comments

The aforementioned signs and symptoms should be considered contraindications for such treatments as traction and joint mobilizations.

• ​Testing for

To assess the strength of the neck flexors (SCM, anterior scalene, supra and infrahyoids, longus colli and capitis, and rectus capitis anterior).

• Test Positioning

The client is supine.

• Action

The client abducts their arm to 90°, flexes the elbows to 90°, and rests their dorsal hands on the table.

The client tucks their chin and then lifts their head off the table.

The client keeps the head lifted off the table (Grade 3). The client resists therapist posteriorly-directed pressure (Grade 5).

• Positive finding

Weakness of Anterior Neck Flexors if the client is unable to keep the neck in flexion against gravity or the therapist’s pressure.