Utility of Provocative Test Positivation Time in Carpal Tunnel Syndrome Severity Assessment

Abstract

Background: Carpal Tunnel Syndrome (CTS) provocative tests, such as Phalen, reverse Phalen, Tinel and compression, are solely used to help diagnosis. However, there are limited data about the application of these clinical tests for severities determination. Methods: A total of 64 patients with confirmed CTS were included. Three groups of mild, moderate, and severe were then defined based on the electrodiagnostic (EDx) test. The time to turning positive for Phalen, reverse Phalen, and compression tests were recorded. Initially, the percentage of positive results were compared among three groups of disease severity. Then, test positivation time was categorized into two groups of below and above 30 s, and comparison was made among groups with regard to this threshold. Finally, correlational analysis between mean positivation time and EDx quantitative parameters was conducted. Results: We found no difference between the three groups of disease severity, and there was no correlation between the time duration for three tests to become positive and EDx severity parameters. Conclusions: CTS clinical provocative tests are not of use in evaluation of disease severity.