TABLE 4.

Symptoms are mechanically irritable.

A. Condition is severe:   ● Poor tolerance to any time vertical   ● Bed bound due to cervical symptoms   ● Need to use a walker or wheelchair due to moderate or intermittently severe problems with coordination and balance rather than pain or weakness, or restricted to bed due to cervical symptoms   ● Extreme cervical spine guarding with fear of movement secondary to severe reactivity   ● Choking, trouble swallowing, and voice changes   ● Profound visual disturbances   ● Severe nausea with any neck movement   ● Functional outcome measure relevant to UCI classified as Severe B. Condition is easily flared:   ● UCI flares are disproportionate compared to provoking insult or activity. e.g., aggravated by minor rapid/unexpected movements/perturbations, traveling in car/bus, prolonged postures.   ● Presyncope, syncope, drop attacks or seizure-like episodes with neck extension or rotation.   ● History of excessive provocation associated with previous conservative care including hands-on manual therapy or exercise. C. Prolonged time to calm after flare:   ● Provoked UCI symptoms take excessive time to settle to pre-flare state: e.g., more than 24 h for pain or more than several hours for neurological symptoms   ● Pt regularly needs to resort to wearing a cervical collar or bedrest to ease symptoms after a flare   ● Inability to tolerate being upright for > 24 h after flare Grading mechanical irritability   ● Low irritability:    ∘ A, B, and C are all typically absent, or    ∘ B or C might be occasionally present at a low level.   ● Moderate irritability:    ∘ A, B, or C are intermittently present, or    ∘ A or B or C is frequently present, but not all three consistently.   ● High irritability:    ∘ A, B, and C are all frequently present.