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Neck Assessment

Physiotherapy · Subjective & Objective Examination

NECK / CERVICAL
DH
RightLeft
RightLeftBilat
1

Presentation & Red Flags

Red flags — screen & tick
Consider urgent / further review if any of. Myelopathy: dexterity loss, clumsiness, gait, hyperreflexia, Hoffmann, Babinski. VBI: 5 D's & 3 N's.
No red flagsLoss of hand dexterityHand clumsinessGait disturbanceHyperreflexiaHoffmann signBabinski sign5 D's (dizziness, diplopia, dysarthria, dysphagia, drop attacks)3 N's (nausea, numbness, nystagmus)Facial numbnessSigns of infectionTumoral historyFractureNeurological deficit
2

History

3

Pain

Body chart
Mark pain location, type & radiation
No pain
0
1
2
3
4
5
6
7
8
9
10
Worst
Morning
Afternoon
Evening
Night
Plot key events along the line — injury, flare-ups, treatments, return to activity, milestones.
Onset Today
4

Lifestyle & Context

Sleep
Diet
Smoking
Alcohol
5

Clinical Reasoning Framework

Characterise the presentation — circle / annotate the relevant descriptors on each strip.
Diagnosis
Diagnosis
Stage of disorder
Stage of disorder
Pain features
Pain features
6

Flags & Whole-Person Considerations

Flags framework
7

Goals

8

Objective — Neck

Observation
Postural observation
Forward head postureCervical alignmentThoracic kyphosisScapular position
Range of movement + pain record response and pain for each
Movement1 movementRepetitionOverpressurePassive
Flexion
Extension
Rotation — right
Rotation — left
Inclination — right
Inclination — left
Chin in
Chin out
Combined movements
Movement1 movementRepetitionOverpressurePassive
Extension + rotation
Flexion + rotation
Manual assessment
Passive accessory movementSegment(s) / levelFinding / mobility
PA central
UPA unilateral
PL transverse glide
Distraction
Neurological screen
Cervical radiculopathy
Wainner cluster — ≥ 3 of 4 positive
TestRightLeft+ / −
Spurling test
Cervical distraction test
ULNT1 (median nerve)
Cervical rotation < 60°
Neurodynamic tests
Special testRightLeftFinding / Notes
ULNT1 — median nerve
ULNT2B — radial nerve
ULNT3 — ulnar nerve
Symptom modification
Improvement of symptoms with
Upper thoracicNeurodynamicChin-inShoulder
9

Functional Assessment

Functional tests
TaskRightLeftObservation / Notes
Deep neck flexor endurance norm 30 s
Cervical extensor endurance norm 200 s
Overhead reach
Wall slide
Push-up scapula
Quadruped shoulder tap
Quadruped dissociation upper / lower cervical
Active lateral
Repositioning test — rotation
Repositioning test — flexion
Others
Stability
10

Adjacent Joints

Scapula / shoulder
Scapular tests
TestRightLeftObservation / Notes
Scapular Assistance Test (SAT)
Scapular Retraction Test (SRT)
Scapular Dyskinesis Test
Dynamic stability
TaskRightLeftObservation / Notes
Serratus wall slide
Lower trap raise
Y raise
Prone T
Prone Y
Thoracic spine
Mobility
MovementRightLeftObservation / Notes
Flexion
Extension
Rotation
Side flexion
Functional
TaskRightLeftObservation / Notes
Open book
Cat-camel
Seated rotation
Temporomandibular joint (TMJ)
Pain
Mouth opening (mm)
Deviation
Palpation
11

Others

12

Retest

DateTest / measureResultNotes
13

Questionnaires

Patient-reported outcome measures — record the score at baseline and at each retest.
QuestionnaireDateScoreNotes / interpretation
Neck Disability Index (NDI)
Örebro Musculoskeletal Pain Questionnaire
PHQ-2 — depression screen
DN4 — neuropathic pain
14

Hypothesis diagnostic