Treatments & Therapies

Cranio-Corpo-Graphie – Treatment, Effects & Risks


The cranio-corpo-graphie is a measuring method for the determination, analysis and documentation of balance disorders .

The method was first presented in 1968 and is also used for the objective and standardized documentation of the results of certain examination methods such as the Unterberger step test, the Romberg test and some other generally recognized diagnostic methods. The CCG is an examination method recognized by the professional association within the G-41 guideline (work with a risk of falling).

What is cranio-corpo-graphy?

Cranio-Corpo-Graphie (CCG) was first introduced in 1968 by the German neurotologist 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 procedure is computer-aided and the integrated algorithms allow immediate analysis. The method is mainly used in occupational medicine to fulfill the trade association guideline G-41 for work at workplaces with a risk of falling and primarily serves to prove suitability for work at workplaces with a risk of falling. In addition, the CCG is used to examine balance disorders of all kinds, even in “normal patients”.

To mark the movements of the head and shoulders , the subject wears a helmet with two lamps and two more lamps on the shoulders. The movement patterns are recorded by an instant camera located above the subject. Since 1993 there has been a further developed procedure in which the light markers are replaced by ultrasonic markers .

Function, effect & goals

One of the main areas of application of cranio-corpo-graphy is to determine suitability for work at workplaces where there is a risk of falling in accordance with trade association guideline G-41. The suitability can B. with the Romberg standing test and the step test according to Unterberger.

To carry out the Romberg test, the subject or patient stands upright on both feet in a closed position with outstretched arms and closed eyes. It is important that there are no visual or acoustic orientation options, such as a bright light at one point in the room or a sound source (e.g. a ticking clock). During the standing test, the compensating movements of the body are recorded using the light or ultrasound markers and then evaluated.

By gently pushing the body, the experiment can be carried out under somewhat more difficult conditions. If the compensatory movements of the body exceed a certain level and increase in the course of the experiment or the experiment has to be stopped due to the risk of falling, there is very likely a coordination problem caused by neurons. A tendency to fall to one side is more indicative of a disorder in one of the macula organs (sacculus or utricle) that are responsible for detecting linear accelerations within the vestibular system (organs of equilibrium ).

The Unterberger step test is about testing the reflex pathways between the balance centers in the brain and the spinal cord (vestibulospinal reflexes). The stepping test was named after the Austrian doctor Siegfried Unterberger and consists of stepping evenly on the spot with your eyes closed. The same preconditions apply as in the Romberg experiment. If the subject or patient has unintentionally and unconsciously turned more than 45 degrees after 50 steps, the result is considered abnormal. Accidental rotation of more than 45 degrees within 50 steps suggests a lesion of a specific region in the cerebellum or indicates a problem with the vestibular system.

The CCG procedure also supports specialized examination methods such as the LOLAVHESLIT, the NEFERT and the WOFEC test. LOLAVHESLIT is an acronym made up of the terms longitudinal, lateral and vertical, head sliding-test. While sitting, the patient performs successive and repeated head rotations and head movements, which are recorded using CCG and immediately evaluated. The test allows conclusions to be drawn about movement disorders in the neck and diseases associated with the cervical vertebrae and the spinal cord.

With the NEFERT (Neck Flex Rotation Test) sprains and stiffness of the neck as well as any whiplash injuries can be detected. 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.

Risks, side effects & dangers

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 an infarction of the cerebellum or the brainstem , diagnostic imaging methods such as magnetic resonance imaging (MRI), computed tomography (CT) or functional magnetic resonance imaging (fMRI) should be resorted to for the benefit of 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 Health and Safety Act, but employers are obliged not only to train their employees who carry out work with a risk of falling, but also to require them to provide proof of health in accordance with the G-41 guideline of the employers’ liability insurance association.

Evidence of the ability to balance and the full functionality of the musculoskeletal system are part of the required proof of health. The health certificate must be renewed every 36 months under the age of 25, every 24 to 36 months between the ages of 25 and under 50 and every 12 to 18 months from the age of 50.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.