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Efficacy of a new provocative test for carpal tunnel syndrome: the straight arm raise (SAR) test

Efficacité d’un nouveau test déclenchant pour le syndrome du canal carpien: le Test du bras levé tendu

  • K. SakthivelEmail author
  • S. Madan
  • D. O’ Connor
  • A. W. Samuel
Original Article
  • 92 Downloads

Abstract

There are many clinical tests to help diagnose carpal tunnel syndrome. The purpose of this study was to evaluate the straight arm raise (SAR) test and compare it with the other tests in a prospective study. Sixty-nine patients who presented with classical symptoms of carpal tunnel syndrome were assessed from October 1998 to April 1999. Four patients (six wrists) had negative nerve conduction studies and hence were excluded from the study. This left 65 patients (90 wrists) that included 30 men (40 wrists) and 35 women (50 wrists). Their mean age was 57 (32–89) years. The control group consisted of 25 subjects (50 wrists). The SAR test was performed by raising the arm above the head with full abduction of the shoulder, full extension of the elbow and with the wrist in a neutral position. The SAR test was most sensitive (P<0.05). It was found that the best cut off time for the SAR test was 35 s, for Phalen’s test was 58 s, for nerve compression test with or without wrist flexion was 30 s. Our findings suggest a significant role for the SAR test in diagnosing CTS with a cut off time of 35 s.

Keywords

Carpal tunnel syndrome Neural conduction Epidemiology Sensitivity and specificity Predictive value of tests 

Résumé

Il existe plusieurs tests cliniques pour poser le diagnostic de syndrome du canal carpien. Le but de ce travail prospectif était d’évaluer le Straight Arm Raise (SAR) et de le comparer aux autres tests. Méthode: 69 patients qui présentaient les signes cliniques de syndrome du canal carpien ont été inclus d’octobre 1998 à avril 1999. Quatre patients (6 poignets) avaient un électromyogramme négatif et ont de ce fait été exclus de l’étude. 65 patients ont donc été inclus (90 poignets) , 30 hommes et 35 femmes dont l’âge moyen était de 57 ans (32–89 ans). Le groupe contrôlé comprenait 25 sujets (50 poignets). Le Straight Arm Raise était réalisé en portant le bras au dessus de la tête en abduction complète de l’épaule et extension complète du coude, le poignet en position neutre. Résultats: Le SAR était le test le plus sensible (p<0,05). Le délai de positivité du SAR était de 35 secondes, celui du test de Phalen de 58 secondes, celui du test de compression du médian, poignet en flexion ou non, de 30 secondes. Conclusion: ces données suggèrent un intérêt pour le test SAR dans le diagnostic du syndrome du canal carpien avec un délai de positivité de 35 secondes.

Mots clés

Syndrome du canal carpien électromyogramme épidémiologie Valeur prédictive 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • K. Sakthivel
    • 1
    • 2
    Email author
  • S. Madan
    • 1
    • 3
  • D. O’ Connor
    • 1
    • 4
  • A. W. Samuel
    • 1
    • 5
  1. 1.Royal Hampshire County HospitalWinchester, HampshireUK
  2. 2.Department of Trauma and OrthopaedicsSouthampton University, Hospitals trustSouthampton, HampshireUK
  3. 3.Department of Trauma and OrthopaedicsChesterfield Royal InfirmaryChesterfieldUK
  4. 4.Department of Trauma and OrthopaedicsRoyal Bournemouth HospitalBournemouthUK
  5. 5.Department of Trauma and OrthopaedicsRoyal Hampshire County hospitalWinchesterUK

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