Execution:
- Patient is in supine position
- The examiner grips and stabilizes the spinous process of C2
- The examiner assesses range of motion and end-feel of side-bending on both sides
- The examiner then assesses range of motion and end-feel on both sides for rotation
Positive Outcome: Side-bending: More than minimal side-bending and/or soft end-feel.
Rotation: Excessive range of motion compared to the other side and/or a soft end-feel
| Study | Reliability | Sn | Sp | LR+ | LR- |
| Hutting et al. (2013) | NA | 69-72 | 96-100 | 16.37-94.09 | 0.33-0.29 |
| Piekartz et al. (2019): Rotation |
NA | 80 | 69.2 | 2.6 | 0.29 |
| Piekartz et al. (2019): Lateral Flexion |
NA | 80 | 76.9 | 3.46 | 0.26 |
| Comment: Ipsilateral side-bending and rotation assesses the contralateral alar ligament. Due to the low sensitivity this test cannot exclude instability, but moderately decrease the post-test chance of an alar ligament insufficiency | |||||
