Diagnostic accuracy of the flexion-rotation test and cut-off value in acute whiplash-associated disorders: A secondary analysis of a cross-sectional study

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Brazil)), 2024-11, Vol.28 (6), p.101134, Article 101134
• Main Authors: Anarte-Lazo, Ernesto, Rodriguez-Blanco, Cleofas, Bernal-Utrera, Carlos
• Format: Article
• Language: English
• Subjects: Cross-Sectional Studies; Diagnostic accuracy; Flexion-rotation test; Headache - physiopathology; Humans; Range of Motion, Articular; Rotation; Sensitivity and Specificity; Whiplash Injuries - physiopathology; Whiplash-associated disorders
• ISSN: 1413-3555; 1809-9246; 1809-9246
• DOI: 10.1016/j.bjpt.2024.101134

•FRT is impaired in those people who present with headache after a whiplash injury.•The FRT demonstrated moderate accuracy to diagnose the presence of headache in this population.•The cut-off value for considering FRT as positive is 31.5° in people with whiplash-associated disorders. Headache is common in people with whiplash-associated disorders (WAD). Upper-cervical structures may be involved in the presence of headache, and the flexion-rotation test (FRT) has been widely studied to assess cervicogenic headaches. To evaluate the diagnostic accuracy of the FRT for the presence of headache in people with WAD, and its cut-off value. In this secondary analysis from a previously published study 47 people with WAD were consecutively recruited, 28 with and 19 without headache. FRT was assessed by a single blinded evaluator, with production of headache during the test as the reference standard. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were assessed through cross-tabulation. The cut-off value was calculated based on the Youden's Index. The positivity of the test was defined based on: a) range of motion (ROM)