Impairment: OA Limited Flexion  

   Intervention: Joint Mob    Intensity/Progression: Low​

› Mock client (age/gender): 30-year-old male​

› Brief Description:  Patient in supine, have neck
slightly flexed, PTs hand under occiput and other hand
on chin to provide counterforce. Slide occiput
posteriorly on the atlas moving along an axis through
the external auditory meatus, ensuring the axis
of rotation does not move, performing
a Kaltenborn grade 3 mobilization.​
› Dosage: 5-10 seconds holds​until joint moves with less
restriction.
› Brief Rationale: By doing this mobilization the patient
will gain cervical flexion of the C0-C1 joint specifically,
without the lower cervical spine (C2-
C7) compensating. Performing joint mobilizations may
help improve ROM by increasing capsular and
ligamentous stability. ​ Start Position
› Reference: González Rueda V, López de Celis C, Barra
López ME, Carrasco Uribarren A, Castillo Tomás S,
Hidalgo García C. Effectiveness of a specific manual
approach to the suboccipital region in patients with
chronic mechanical neck pain and rotation deficit
in the upper cervical spine: Study protocol for a
randomized
controlled trial. BMC Musculoskelet Disord. 2017;18(1). End Position
doi:10.1186/s12891-017-1744-​ (X is at C2)

Group Member Names: Anna Zaremba and Amanda Floen

 Impairment: OA Limited Flexion    Intervention: PNF Stretching    Intensity/Progression: Moderate

› Mock client (age/gender): 30-year-old male​

› Brief Description: Patient lying supine, therapist
stabilizes C2 with their thumb and index finger of
one hand and has their other hand on occiput.
While doing so the therapist nods the patients
head forward into flexion. While in flexion, perform
hold relax technique by having pt roll eyes upward to
contract, then have them look down when the head
is nodded forward.

› Dosage: 
– 10 sec stretch, 5-10 sec contraction
– 3-4 reps
– 1x/day, 5x/week
› Brief Rationale: Increase ROM in OA flexion by Start Position
increasing tissue extensibility/flexibility in the
suboccipital and cervical extensor muscles. ​

› Reference: Lempke L, Wilkinson R, Murray C, Stanek

J. The Effectiveness of PNF Versus Static Stretching
on Increasing Hip-Flexion Range of Motion. J Sport
Rehabil. 2018 May 1;27(3):289-294. doi:
10.1123/jsr.2016-0098. Epub 2018 May 22. PMID:
28182516.
End Position

Group Member Names: Anna Zaremba and Amanda Floen

Impairment: OA Limited Flexion    Intervention: Resistance Exercise    Intensity/Progression:
High

› Mock client (age/gender): 30-year-old male

› Brief Description: Have band wrapped around the
front of the patient's head secure in a door hinge
behind. Have patient chin tuck and flex neck.

› Dosage: 12 reps X 3 sets 

– Once a day, 4x/week
– Goal is strengthening/endurance: 80% of 1RM ​
– Red band (Regress to yellow if too difficult and increase to
green if not fatigued by rep 18)

› Brief Rationale: Strengthen deep cervical flexors

to increase stability and range of motion.​
Start Position
› Reference: Lasevicius T, Ugrinowitsch C,
Schoenfeld BJ, Roschel H, Tavares LD, De Souza
EO, Laurentino G, Tricoli V. Effects of different
intensities of resistance training with equated
volume load on muscle strength and
hypertrophy. Eur J Sport Sci. 2018 Jul;18(6):772-
780. doi: 10.1080/17461391.2018.1450898.
Epub 2018 Mar 22. PMID: 29564973.

End Position
Group Member Names: Anna Zaremba and Amanda Floen