Piekartz Harry Von1, Rakan Maloul2, Marisa Hoffmann3, Toby Hall4, Med Martin Ruch5, Nicolaus Ballenberger6. 1. a Department of Physical Therapy and Rehabilitationscience , University of Applied Science Osnabrueck , Osnabrueck , Germany. 2. b Department of Physical Therapy and Rehabilitation , University of Applied Science Osnabrück , Osnabrueck , Germany. 3. c Privatpraxis Schwerpunkte Manuelle Therapie Kiefer-/Kopf-/Gesichtsschmerz , Nieder-Olm , Germany. 4. d School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia. 5. e Die Radiologen Weiterstadt Dr. Martin Ruch , Weiterstadt- D , Germany. 6. f Department of Physical Therapy and Rehabilitationscience , University of Applied Science , Osnabrueck , Germany.
Abstract
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.
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.
Authors: Kerstin Luedtke; Thomas Schoettker-Königer; Toby Hall; Christine Reimer; Maike Grassold; Petra Hasselhoff-Styhler; Christian Neulinger; Max Obrocki; Philipp Przyhoda; Axel Schäfer Journal: BMC Musculoskelet Disord Date: 2020-08-11 Impact factor: 2.362