Article

The aim of this study was to estimate the validity of the Upper Limb Neurodynamic
Test 1 (ULNT1) for the diagnosis of Carpal Tunnel Syndrome (CTS) with blind
comparison to a reference criterion of a compatible clinical presentation and
abnormal nerve conduction.
47 subjects with suspected CTS were enrolled. All patients were tested with nerve conduction studies and ULNT1. Considering results
as positive in the presence of reproduction of symptoms on affected upper limb,
or side-to-side differences in elbow extension, or symptoms modified by lateral
neck side-bending, we estimated sensitivity as 91.67%, specificity as 15%,
positive likelihood ratio as 1.0784, negative likelihood ratio as 0.5556, and
post-test probability for negative test as 40%. Using a new criterion, i.e. the
reproduction of symptoms only in the first three digits of the affected hand, we
estimated sensitivity as 54.17%, specificity as 70%, positive and negative
likelihood ratios as 1.8056 and 0.6548, respectively, and post-test probability
for positive test as 68%. Our investigation suggests that the reproduction of the
typical current CTS symptoms in the affected hand during ULNT1 testing, improves
estimation of the probability of the presence of this condition, even if this
test alone cannot be used to diagnose CTS.
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Langue : ANGLAIS