Diagnostic accuracy and validity of three manual examination tests to identify alar ligament lesions: results of a blinded case-control study. (15th March 2019)

• Record Type: Journal Article
• Authors: Harry Von, Piekartz; Maloul, Rakan; Hoffmann, Marisa; Hall, Toby; Ruch, Med Martin; Ballenberger, Nicolaus
• Is Part Of: Journal of manual & manipulative therapy. Volume 27:Number 2(2019)
• Page Start: 83
• Page End: 91
• Publication Date: 2019-03-15
• Subjects: Alar ligaments -- clinical tests -- validity – MRI; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; 615.82
• DOI: 10.1080/10669817.2018.1539434
• Languages: English
• ISSNs: 1066-9817

Abstract

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.