The Cranio-Corpo-Graphics is a measuring method for the determination, analysis and documentation of equilibrium dysfunction.
The procedure was presented for the first time in 1968 and is used for the objective and standardized documentation of the results of certain examination procedures such as the Unterberger-Tretversuch, the Rombergversuch and some other generally recognized diagnostic procedures. The CCG is an examination procedure recognized by the professional association within the guideline G-41 (work with risk of falling).
What is the Cranio-Corpo-Graphie?
Cranio-Corpo-Graphie (CCG) was first presented in 1968 by the German neurootologist Claus-Frenz Claussen. The CCG does not contain its own examination procedure, but serves to improve and objectify the documentation of recognized examination methods for the areas of balance ability and balance disorders.
The process is computer-aided and the integrated algorithms allow immediate analyzes. The procedure is mainly used in occupational medicine to comply with the professional association guideline G-41 for work at workplaces where there is a risk of falling and is primarily used to demonstrate suitability for work at workplaces at risk of falling. In addition, the CCG is used to examine all kinds of balance disorders, even in "normal patients".
To mark the movements of the head and shoulder, the test person wears a helmet with two lamps and two more lamps on the shoulders. The movement patterns are recorded by an instant camera, which is located above the test subject. Since 1993 there has been a further developed process in which the highlighter markers are replaced by ultrasonic markers.
Function, effect & goals
One of the main areas of application of Cranio-Corpo-Graphie is the determination of the suitability for work at workplaces with a risk of falling according to the professional association guideline G-41. The suitability can e.g. B. can be demonstrated with the Romberg standing test and the step test according to Unterberger.
To carry out the Romberg experiment, the test person or patient stands upright on both feet in a closed position with arms outstretched and eyes closed. It is important that there are no visual or acoustic options for orientation, such as a bright light at one point in the room or a sound source (e.g. ticking clock). During the standing test, the compensatory movements of the body are recorded using the light or ultrasound markers and then evaluated.
The experiment can be carried out under somewhat more difficult conditions by gently pushing the body. If the compensatory movements of the body exceed a certain level and intensify during the course of the experiment, or if the experiment has to be stopped due to the risk of falling, there is very likely a neuronally caused coordination problem. A tendency to fall to a certain side indicates a disruption of one of the macular organs (sacculus or utriculus), which are responsible for recording linear accelerations within the vestibular system (equilibrium organs).
The Unterberger stepping attempt is about checking the reflex pathways between the centers of equilibrium in the brain and the spinal cord (vestibulospinal reflexes). The step attempt was named after the Austrian doctor Siegfried Unterberger and consists in stepping evenly on the spot with your eyes closed. The same preconditions apply as for the Romberg experiment. If the test person or patient has involuntarily and unconsciously turned more than 45 degrees after 50 steps, the result is considered to be abnormal. Unintentional rotation of more than 45 degrees within 50 steps suggests a lesion in a specific region in the cerebellum or suggests a problem with the vestibular system.
The CCG procedure also supports specialized examination methods such as the LOLAVHESLIT, NEFERT and WOFEC tests. LOLAVHESLIT is an acronym made up of the terms longitudinal, lateral and vertical, head sliding-test. While sitting, the patient executes head turns and head movements one after the other and repetitively, which are recorded using CCG and immediately evaluated. The test allows conclusions to be drawn about movement disorders in the neck and identifies diseases that are related to the cervical vertebrae and the spinal cord.
The NEFERT (Neck Flex Rotation Test) can detect sprains and stiffness of the neck as well as any whiplash injuries. The procedure was introduced in 1998. An additional test method for detecting gait ataxia is the so-called WOFEC test (Walk on Floor Eyes Closed), the results of which can also be documented, interpreted and saved using CCG.
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Cranio-Corpo-Graphie is a non-invasive recording and diagnostic procedure that cannot be associated with any dangers or side effects.
However, if there is an acute suspicion of a cerebellar infarction or the brain stem, diagnostic imaging methods such as magnetic resonance imaging (MRI), computed tomography (CT) or functional magnetic resonance imaging (fMRI) should be used for faster and more precise diagnoses. In this respect, the suspicion of a brainstem or cerebellar infarction can be understood as a contraindication for the use of a CCG.
The German Occupational Safety and Health Act (ArbSchG) implements the binding EU directives on occupational safety and is aimed at both employers and employees. Work with a risk of falling is not explicitly listed in the Occupational Safety and Health Act, but employers are obliged not only to provide their employees who carry out an activity with a risk of falling, but also to require them to provide proof of health in accordance with the professional association guideline G-41.
Proof of the ability to balance and the full functionality of the musculoskeletal system are part of the required health certificate. If you are under 25 years of age, the health certificate must be repeated every 36 months, between the ages of 25 and under 50 years every 24 to 36 months and from the age of 50 years every 12 to 18 months.
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