. 2016 Dec;51(12):1037–1044. doi: 10.4085/1062-6050-51.12.15

Table 2.

Clinical Test Utility in the Diagnosis and Identification of Origin of Symptoms in Concussion Testing

Clinical Test	Positive Test	Origin	Symptom	Treatment	Criterion Validity	Advantages and Disadvantages
Cervical joint-reposition error test^8,37	Increased error in repositioning the neck to a neutral starting position	Damage to muscle spindles in the neck	Neck pain and stiffness	Neck-position–sense training	Specificity = 92%	Advantages: inexpensive, quick, and objective
Cervical joint-reposition error test^8,37		Damage to muscle spindles in the neck	Neck pain and stiffness	Neck-position–sense training	Sensitivity = 82%	Disadvantage: requires some equipment (ie, pen laser, target, and chair)
Smooth-pursuit neck- torsion test^32,38	Performing tracking task in the rotated position evokes symptoms	Has been linked to disturbances in the neck	Cervicogenic dizziness, vertigo, and balance disturbances	Manual therapy and gaze-stabilization training	Specificity = 91%	Advantages: quick and can be objectively measured with equipment
Smooth-pursuit neck- torsion test^32,38		Has been linked to disturbances in the neck	Cervicogenic dizziness, vertigo, and balance disturbances	Manual therapy and gaze-stabilization training	Sensitivity = 90%	Disadvantage: subjective when addressing only symptom provocation
Head-neck differentiation test⁴⁰	Head cannot hold still while body spins on chair or with other symptom provocation	Cervicocollic reflex	Dizziness, vertigo, and balance disturbances	Head- and neck- differentiation training	Specificity and sensitivity unknown	Advantages: quick, requires no equipment, and allows the clinician to isolate neck movement while holding the head still
Head-neck differentiation test⁴⁰		Cervicocollic reflex	Dizziness, vertigo, and balance disturbances	Head- and neck- differentiation training	Specificity and sensitivity unknown	Disadvantage: limited to subjective report of symptoms
Cervical flexion-rotation test^29,39	Onset of symptoms with head movement	Afferent information from cervical proprioceptors to central nervous system does not match other sensory information	Cervicogenic dizziness	Manual therapy	Specificity = 91%	Advantages: quick, requires no equipment, and movement is only at the neck
Cervical flexion-rotation test^29,39	Onset of symptoms with head movement		Cervicogenic dizziness	Manual therapy	Sensitivity = 90%	Disadvantage: limited to subjective report of symptom provocation
Motor-control assessment of deep cervical flexors and extensors³⁹	Inability to dissociate head and neck movements, failed endurance, and onset of dizziness with movement	Vestibulocollic reflex	Dizziness, vertigo, balance disturbances, and headache	Manual therapy	Specificity and sensitivity unknown	Advantages: quick and requires no equipment
		Vestibulocollic reflex	Dizziness, vertigo, balance disturbances, and headache	Manual therapy	Specificity and sensitivity unknown	Disadvantage: limited to subjective report of symptom provocation