title: Validity of the Upper Limb Neurodynamic Test 1 for the diagnosis of Carpal Tunnel Syndrome. The role of structural differentiation.
abstract: BACKGROUND
  Several studies have analysed the use of the Upper Limb Neurodynamic Test 1 (ULNT1) for diagnosing Carpal Tunnel Syndrome (CTS) obtaining weak diagnostic accuracy, which could be related to the lack of consensus in the selected diagnostic criteria of ULNT1.
  
  
  OBJECTIVE
  To determine the concurrent validity of ULNT1 in comparison to Nerve Conduction Studies (NCS) for the diagnosis of CTS, considering the structural differentiation (SD) as an essential part of the diagnosis.
  
  
  METHODS
  Prospective diagnostic test study.
  
  
  METHODS
  Individuals with suspected CTS referred for NCS were invited to voluntarily participate in the study. Each participant was tested with NCS and ULNT1. ULNT1 result was considered positive when the patient's clinical symptoms were reproduced during the test and symptoms changed during contralateral neck side bending (SD).
  
  
  RESULTS
  58 Participants (17 men, 44 women) with suspected CTS and a total of 95 limbs were examined using the NCS and ULNT1. Sensitivity of the ULNT1 was 57.9%, specificity was 84.2%, and the positive and negative likelihood ratios were 3.67 and 0.50 respectively.
  
  
  CONCLUSIONS
  Results obtained in the study may indicate the ability of the ULNT1 to generate small shifts from pre-test to post-test probability. However, imprecision in the CIs limits interpretation from the data.
  
  
  METHODS
  1b.
authors.affiliation: Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain. Electronic address: ebueno@unizar.es.
authors.forename: Elena
authors.initials: E
authors.lastname: Bueno-Gracia
authors.affiliation: Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Tricás-Moreno
authors.affiliation: Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Fanlo-Mazas
authors.affiliation: Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Malo-Urriés
authors.affiliation: Department of Clinical Neurophysiology, Miguel Servet Hospital, Zaragoza, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Haddad-Garay
authors.affiliation: Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Estébanez-de-Miguel
authors.affiliation: Department of Physiatrist and Nursery, Faculty of Heath Sciences, University of Zaragoza, Zaragoza, Spain.
authors.forename: César
authors.initials: C
authors.lastname: Hidalgo-García
authors.affiliation: Associate Professor in the School of Health Sciences, Oakland University, Rochester, MI, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Krauss
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D009460:Neurologic Examination / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D034941:Upper Extremity / Q000294:innervation*
keywords: Carpal tunnel syndrome; Diagnosis; Manual therapy; Neurological evaluation