24/11/2023
How should the upper limb tension test be performed and what comprises a positive test result? 🙋♂️
👉 Upper limb tension tests (ULTT), also called upper limb neurodynamic tests (ULNT), are a commonly used neurodynamic technique by clinicians to evaluate nerve gliding and neural tension in patients. https://pubmed.ncbi.nlm.nih.gov/15891982/
👉 Neurodynamic tests aim to investigate if a peripheral nerve is contributing to the patients’ pain, resulting in peripheral neuropathic pain, by moving and stretching the peripheral nerves. https://pubmed.ncbi.nlm.nih.gov/22402638/
👉 When utilizing a neurodynamic test, the assessor manipulates the limb into various positions with the aim of increasing tension on peripheral nerves. https://www.sciencedirect.com/science/article/pii/S0031940605655241,
👉 Systematic reviews state that the validity of the ULTT is unclear, due to heterogeneity of test procedures and variability in the definition of a positive test. https://pubmed.ncbi.nlm.nih.gov/30665045/, https://pubmed.ncbi.nlm.nih.gov/28838857/
💡 As a consequence a brand new systematic review by Verhagen and colleagues tries to give answers to the fundamental questions of test procedure standardization and cut-offs for positive test results. https://www.sciencedirect.com/science/article/pii/S1413355523000795
📊 They found nine diagnostic test accuracy studies of which four included patients with cervical radiculopathy (CR), four studies patients with carpal tunnel syndrome (CTS), and one included both patients.
📊 The most evaluated test was the ULTT1, with in total 13 test procedures described in eight studies. Moreover, they found a wide variety of test procedures and criteria for a positive test.
📌 Based on their findings, they propose a more standardised test procedure of the ULTT1 in patients with CR as well as CTS.