Execution:
- Have the patient in supine lying position
- Depress the patient’s shoulder, abduct to 110°, and flex the elbow to 90°
- Extend the wrist and fingers(including the thumb), supinate the forearm, and externally rotate the shoulder
- Slowly extend the elbow until the patient complains of familiar symptoms
- Confirm that the findings are due to nerve stretch by flexing the elbow a little to create slack and ask the patient to laterally flex their neck to the contralateral side, which should increase the symptoms again
Positive Outcome: The patients familiar arm symptoms like shooting pain or paresthesia are reproduced. Some authors score the test negative in case of a marked decrease of mobility (>10°)
| Study | Reliability | Sn | Sp | LR+ | LR- |
| Wainner et al. (2003) | Inter-rater к=0.76 | 97 | 22 | 1.3 | 0.12 |
| Apelby-Albrecht et al. (2013) | NA | 85 | 75 | 3.31 | 0.23 |
| Koulidis et al. (2019) | NA | NA | NA | NA | NA |
| Schmid et al. (2009) | Inter-rater к=0.54 | NA | NA | NA | NA |
| Hanney et al. (2014) | Inter-rater к=0.36 | NA | NA | NA | NA |
| Grondin et al. (2021) | NA | 59.26 | 75.86 | 2.46 | 0.54 |
| Comment: A negative ULTT/ULNT A/1 considerably can be used to exclude cervical radicular syndrome. Based on the available evidence ULNTs cannot be utilised as a stand-alone test for the diagnosis of CTS. Limited evidence suggests that ULNTs may be clinically relevant for the diagnosis of CR, but only as a “ruling out” strategy | |||||
