In a neck pain patient, a premanipulative hold in passive rotation is performed to screen for vertebral basilar artery insufficiency. What duration is recommended for the hold?

• A. 10 seconds
• B. 30 seconds
• C. 60 seconds
• D. 90 seconds

Answer: (A)

Screening for vertebral-basilar artery insufficiency is done by placing the neck in a provocative position and holding it briefly to see if symptoms develop, without risking prolonged compression of the arteries. The recommended duration is about 10 seconds in passive rotation. This short hold is long enough to reveal early signs such as dizziness, visual changes, dysarthria, or ataxia, but short enough to minimize the risk of ischemia if the vertebral arteries are compromised. If any adverse symptoms appear, stop immediately and reassess; longer holds would unnecessarily increase risk during this safety screen.