This assessment is designed to measure the deep neck flexor muscles function in terms of motor control, strength, and muscle endurance. The Deep Neck Flexor (DNF) muscles are comprised of the longus capitis, longus colli, rectus capitis anterior, and rectus capitis lateralis. The DNF muscles assist in stabilizing the cervical spine during gross neck movements. Patients with neck pain often exhibit reduced deep neck flexor muscle endurance, delayed activation, and errors in neck muscle patterns of activation
Get set-up laying flat on your back with your head/neck supported on a surface. Perform a chin tuck, then lift your head/neck up approximately 1 inch from the surface (you can fit two fingers behind the back of your skull and the surface. Hold this position with the optimal form for as long as you can. Refer to the video for instructions and optimal form.
Some rules to remember with this assessment. Your test time ends when you can no longer maintain optimal form - you either lose your head/neck position or your head/neck drops down towards the surface. You can perform the test twice with a 3-minute rest between each trial, take your best score. Be sure to reference the entire video before performing this assessment again to improve your performance.
Prehab Goals & Normative Values:
Below are a few studies that found different results with the DNF endurance test. Based on the data published, males with and without neck pain tend to have longer neck flexor endurance than females.
Asymptomatic Men (mean = 63.73 seconds), asymptomatic woman (38.43 seconds), mean age 23-26 y.o. - (Painkra et al. 2014)
Asymptomatic Men (mean = 25 seconds), asymptomatic woman (20 seconds) - (Olson et al. 2016)
Asymptomatic group (mean = 39 seconds), group with neck pain (mean - 24 seconds) - (Harris et al, 2005)
Prehab Goal: 45-60 seconds
Painkra JP, Kumar S, Anwer S, Kumar R, Nezamuddin M, Equebal A. Reliability of an assessment of deep neck flexor muscle endurance test: A cross-sectional study. International Journal of Therapy and Rehabilitation. 2014 May;21(5):227-31.
Parazza S, Vanti C, O’Reilly C, Villafañe JH, Moreno JM, De Miguel EE. The relationship between cervical flexor endurance, cervical extensor endurance, VAS, and disability in subjects with neck pain. Chiropractic & manual therapies. 2014 Dec;22(1):10.
Olson LE, Millar AL, Dunker J, Hicks J, Glanz D (2006) Reliability of a clinical test for deep cervical flexor endurance. J Manipulative Physiol Ther 29: 134–8
Harris KD, Heer DM, Roy TC, Santos DM, Whitman JM, Wainner RS (2005) Reliability of a measurement of neck flexor muscle endurance. Phys Ther 85(12): 1349–55
Take the assessment, write down your score, and track your progress throughout the program.