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Diagnostic accuracy and validity of three manual examination tests to identify alar ligament lesions: results of a
Piekartz Harry Von1, Rakan Maloul2, Marisa Hoffmann3
1a Department of Physical Therapy and Rehabilitationscience , University of Applied Science Osnabrueck , Osnabrueck , Germany.
Introduction:
Tests to evaluate the integrity of the alar ligaments are important clinical tools for manual therapists, but there is limited research regarding their validity.
Method:
A single blinded examiner assessed alar ligament integrity using the lateral shear test (LST), rotation stress test (RST) and side-bending stress test (SBST) on a sample of convenience comprising 7 subjects with MRI confirmed alar ligament lesions and 11 healthy people. Alar ligament lesions were identified using both supine and high-field strength upright MRI.
Results:
The RST had a sensitivity of 80% and a specificity of 69.2%. The SBST and the LST both showed a sensitivity of 80% and a specificity of 76.9%. In cases where all three tests were positive, the specificity increased to 84.6%.
Discussion:
Tests of manual examination of alar ligament integrity have some diagnostic utility; however, these findings require further corroboration in a larger sample.
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