Summary

What it measures:

The CROM measures active range of motion (ROM) in the cervical spine and/or neck. This test can be used for any person with cervical spine and/or neck pain or loss of motion due to various pathologies and injuries.

Conditions and test variations in this summary

This summary contains information on the use of smartphone apps, goniometers, inclinometers, CROM device, and tape measures to measure cervical range of motion in patients or clients with cervical spine and/or neck pain or loss of motion.

Target Population:

Patients with neck pain.

Taskforce Recommendations

The Neck Pain: Revision 2017 clinical practice guideline includes the following moderate strength recommendation:

When evaluating a patient with neck pain over an episode of care, clinicians should include assessments of impairments of body function that can establish baselines, monitor changes over time, and be helpful in clinical decision making to rule in or rule out (1) neck pain with mobility deficits, including cervical active range of motion (ROM), the cervical flexion-rotation test, and cervical and thoracic segmental mobility tests; (2) neck pain with headache, including cervical active ROM, the cervical flexion-rotation test, and upper cervical segmental mobility testing; (3) neck pain with radiating pain, including neurodynamic testing, Spurling's test, the distraction test, and the Valsalva test; and (4) neck pain with movement coordination impairments, including cranial cervical flexion and neck flexor muscle endurance tests. 

Clinical Insights

This is a user-friendly and highly available measure that any health care clinician can implement into a ROM or cervical screening. Almost everyone has access to a smartphone and the ability to download goniometric apps. The apps are either included on the device, like the Digital Compass app, or are relatively inexpensive and accessible to the public. Using these methods to measure cervical flexion, extension, and lateral flexion, will reveal accurate and reliable results. However, using these same apps to measure cervical rotation is neither reliable nor valid. (8) Before using the apps and mobile devices as an outcomes measure in clinical settings, studies should be done on patients presenting with cervical problems as well as specific positions. (7)