{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:10:02Z","timestamp":1730765402186,"version":"3.28.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sportverletz Sportschaden"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Einleitung Das Ziel dieser Studie war die Untersuchung der Intertester-Reliabilit\u00e4t und Validit\u00e4t des Lever Sign-Tests. Der Intertester-Reliabilit\u00e4t wurde in bisherigen Studiennoch wenig Beachtung geschenkt. Um Vergleiche mit anderen Studien ziehen zu k\u00f6nnen, wurde zus\u00e4tzlich die Intertester-Reliabilit\u00e4t und Validit\u00e4t des Lachman- und Anterior Drawer-Tests berechnet.<\/jats:p><jats:p>Patienten\/Material und Methoden Eingeschlossen wurden Patienten und Patientinnen zwischen 18 und 50 Jahren mit Verdacht auf Band- und\/oder Meniskus-Verletzungen. Ausschlusskriterien waren Verdacht auf b\u00f6sartige, systemische oder zentralneurologische Erkrankungen, akute Knorpelverletzungen, Verdacht auf Fraktur oder Kenntnis \u00fcber den Kniebefund der Teilnehmenden. Die Tests wurden von einem erfahrenen Orthop\u00e4den und einem Physiotherapeuten randomisiert und verblindet durchgef\u00fchrt. F\u00fcr die Intertester-Reliabilit\u00e4t wurde der Cohen\u2019s Kappa und f\u00fcr die Validit\u00e4t die Sensitivit\u00e4t und Spezifit\u00e4t, der Positiv und Negativ Pr\u00e4diktive Wert und die Positive und Negative Likelihood ratio berechnet. Der MRI-Befund wurde als Goldstandard genutzt.<\/jats:p><jats:p>Ergebnisse Sechsunddreissig Patienten und Patientinnen wurden in die Studie eingeschlossen. Davon waren 27 m\u00e4nnlich (75%) und 9 weiblich (25%). Die Pr\u00e4valenz von vorderen Kreuzbandl\u00e4sionen lag bei 44,4%. Der Cohen\u2019s Kappa (\u03ba) des Lever Sign-Tests lag bei \u03ba=0,6 (KI 95% [0,29, 0,91]), beim Lachman-Test bei \u03ba=0,64 (KI 95% [0,35, 0,93]) und beim Anterior Drawer-Test bei \u03ba=0,63 (KI 95% [0,3, 0,95]). Die Sensitivit\u00e4t des Lever Sign-Tests war f\u00fcr den Orthop\u00e4den und Physiotherapeuten 0,53 und 0,40, die Spezifit\u00e4t 0,89 und 0,79, der Positiv Pr\u00e4diktive Wert 0,80 und 0,60, der Negativ Pr\u00e4diktive Wert 0,70 und 0,62, die Positive Likelihood ratio 4,80 und 1,90 und die Negative Likelihood ratio 0,76 und 0,53.<\/jats:p><jats:p>Schlussfolgerung Die gesch\u00e4tzte Intertester-Reliabilit\u00e4t des Lever Sign-Tests war gut. Der Lever Sign-Test eignet sich als Erg\u00e4nzung zum Lachman-Test, der in der Literatur als validester Test angesehen wird. Die Schw\u00e4chen und Unklarheiten des Funktionsmechanismus des Lever Sign-Tests d\u00fcrfen nicht ignoriert werden und sollten weiter erforscht werden.<\/jats:p>","DOI":"10.1055\/a-2153-1550","type":"journal-article","created":{"date-parts":[[2023,12,4]],"date-time":"2023-12-04T23:58:31Z","timestamp":1701734311000},"page":"187-195","source":"Crossref","is-referenced-by-count":0,"title":["Reliabilit\u00e4t und Validit\u00e4t des Lever Sign Tests bei Verdacht auf Band- und\/oder Meniskus-Verletzung des Knies: ein Vergleich zwischen Orthop\u00e4de und Physiotherapeut"],"prefix":"10.1055","volume":"37","author":[{"given":"David","family":"Cavelti","sequence":"additional","affiliation":[{"name":"Physiotherapy, Kantonsspital Graubunden, Chur, SWITZERLAND"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Grehn","sequence":"additional","affiliation":[{"name":"Kantonsspital Graubunden, Chur, SWITZERLAND"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannu","family":"Luomajoki","sequence":"additional","affiliation":[{"name":"Gesundheit, Institut f\u00fcr Physiotherapie, Z\u00fcrcher Hochschule fur Angewandte Wissenschaften, Winterthur, SWITZERLAND"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"267","DOI":"10.2519\/jospt.2006.2011","article-title":"Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis","volume":"36","author":"A Benjaminse","year":"2006","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref4","first-page":"94","article-title":"Accuracy of Lachman and Anterior Drawer Tests for Anterior Cruciate Ligament Injuries","volume":"1","author":"H Makhmalbaf","year":"2013","journal-title":"Arch Bone Jt Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2794","DOI":"10.1007\/s00167-014-3490-7","article-title":"The \u201cLever Sign\u201d: a new clinical test for the diagnosis of anterior cruciate ligament rupture","volume":"24","author":"A Lelli","year":"2016","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"ref6","first-page":"71","article-title":"Evaluating Different Clinical Diagnosis of Anterior Cruciate Ligament Ruptures In Providers with Different Training Backgrounds","volume":"37","author":"AC Chong","year":"2017","journal-title":"The Iowa Orthopaedic Journal"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1186\/s40064-015-1628-9","article-title":"The arthroscopical and radiological corelation of lever sign test for the diagnosis of anterior cruciate ligament rupture","volume":"4","author":"A Deveci","year":"2015","journal-title":"Springerplus"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"3639693","DOI":"10.1155\/2019\/3639693","article-title":"Diagnostic Accuracy of Lever Sign Test in Acute, Chronic, and Postreconstructive ACL Injuries","volume":"2019","author":"T G\u00fcrp\u0131nar","year":"2019","journal-title":"Biomed Res Int"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2325967117729809","DOI":"10.1177\/2325967117729809","article-title":"Accuracy of the Lever Sign Test in the Diagnosis of Anterior Cruciate Ligament Injuries","volume":"5","author":"KA Jarbo","year":"2017","journal-title":"Orthop J Sports Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2325967118759631","DOI":"10.1177\/2325967118759631","article-title":"Does the Lever Sign Test Have Added Value for Diagnosing Anterior Cruciate Ligament Ruptures?","volume":"6","author":"MC Lichtenberg","year":"2018","journal-title":"Orthop J Sports Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1016\/j.jemermed.2019.09.003","article-title":"Implementing the Lever Sign in the Emergency Department: Does it Assist in Acute Anterior Cruciate Ligament Rupture Diagnosis? 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