PDF(Pubmed)
Abstract：
BACKGROUND: The validity of the ULTT is unclear, due to heterogeneity of test procedures and variability in the definition of a positive test OBJECTIVE: To evaluate test procedures and positive diagnostic criteria for the upper limb tension test (ULTT) in diagnostic test accuracy studies.
METHODS: A systematic review of diagnostic accuracy studies was performed. We conducted a search of the DiTA (Diagnostic Test Accuracy) database and selected primary studies evaluating the diagnostic accuracy of the ULTT. We assessed risk of bias, performed data extraction on study characteristics, test procedures, and positive diagnostic criteria, and performed a descriptive analysis.
RESULTS: We included nine studies (681 participants), four diagnosing people with cervical radiculopathy (CR), four diagnosing people with carpal tunnel syndrome (CTS), and one included both CR and CTS. The risk of bias varied between 2 and 6 out of 6 positive items. Eight studies reported on the ULTT1 (median nerve). Overall, all studies clearly described their test procedures and positive diagnostic criteria although the order of movements and the diagnostic criteria between studies varied. We suggest a more standardised test procedure for the ULTT1 to consist of: 1) stabilising the shoulder in abduction, 2) extending the wrist/fingers, 3) supinating the forearm, 4) externally rotating the shoulder, 5) extending the elbow, and finally 6) performed structural differentiation by side bending (lateral flexion) of the neck. This proposed test procedure should reproduce the symptoms and enables the clinician to evaluate whether symptoms increase/decrease when stressing or relaxing the nerves.
CONCLUSIONS: Based on our findings we proposed a more standardised test procedure for the ULTT1 with accompanying positive diagnostic criteria to facilitate homogeneity in future diagnostic accuracy studies of the ULTT.
METHODS: A systematic review of diagnostic accuracy studies was performed. We conducted a search of the DiTA (Diagnostic Test Accuracy) database and selected primary studies evaluating the diagnostic accuracy of the ULTT. We assessed risk of bias, performed data extraction on study characteristics, test procedures, and positive diagnostic criteria, and performed a descriptive analysis.
RESULTS: We included nine studies (681 participants), four diagnosing people with cervical radiculopathy (CR), four diagnosing people with carpal tunnel syndrome (CTS), and one included both CR and CTS. The risk of bias varied between 2 and 6 out of 6 positive items. Eight studies reported on the ULTT1 (median nerve). Overall, all studies clearly described their test procedures and positive diagnostic criteria although the order of movements and the diagnostic criteria between studies varied. We suggest a more standardised test procedure for the ULTT1 to consist of: 1) stabilising the shoulder in abduction, 2) extending the wrist/fingers, 3) supinating the forearm, 4) externally rotating the shoulder, 5) extending the elbow, and finally 6) performed structural differentiation by side bending (lateral flexion) of the neck. This proposed test procedure should reproduce the symptoms and enables the clinician to evaluate whether symptoms increase/decrease when stressing or relaxing the nerves.
CONCLUSIONS: Based on our findings we proposed a more standardised test procedure for the ULTT1 with accompanying positive diagnostic criteria to facilitate homogeneity in future diagnostic accuracy studies of the ULTT.
摘要：
背景：ULTT的有效性尚不清楚，由于测试程序的异质性和阳性测试定义的可变性目的：评估诊断测试准确性研究中上肢张力测试（ULTT）的测试程序和阳性诊断标准。
方法：对诊断准确性研究进行了系统评价。我们搜索了DiTA（诊断测试准确性）数据库，并选择了评估ULTT诊断准确性的主要研究。我们评估了偏见的风险，对研究特征进行数据提取，测试程序,和积极的诊断标准，并进行了描述性分析。
结果：我们纳入了9项研究（681名参与者），四名诊断患有神经根型颈椎病（CR）的人，四个诊断腕管综合征（CTS）的人，其中一个包括CR和CTS。6个阳性项目中，偏倚的风险在2到6个之间变化。8项研究报道了ULTT1（正中神经）。总的来说,尽管研究之间的运动顺序和诊断标准各不相同,但所有研究都清楚地描述了其测试程序和阳性诊断标准.我们建议对ULTT1进行更标准化的测试程序，包括：1）稳定外展的肩部，2）伸出手腕/手指，3)仰卧前臂，4）外部旋转的肩部，5）延伸的肘部，最后6）通过颈部的侧向弯曲（侧向弯曲）进行结构分化。该提议的测试程序应重现症状，并使临床医生能够评估在紧张或放松神经时症状是否增加/减少。
结论：根据我们的发现，我们提出了一种更标准化的ULTT1测试程序，并伴随阳性诊断标准，以促进未来ULTT诊断准确性研究的同质性。
方法：对诊断准确性研究进行了系统评价。我们搜索了DiTA（诊断测试准确性）数据库，并选择了评估ULTT诊断准确性的主要研究。我们评估了偏见的风险，对研究特征进行数据提取，测试程序,和积极的诊断标准，并进行了描述性分析。
结果：我们纳入了9项研究（681名参与者），四名诊断患有神经根型颈椎病（CR）的人，四个诊断腕管综合征（CTS）的人，其中一个包括CR和CTS。6个阳性项目中，偏倚的风险在2到6个之间变化。8项研究报道了ULTT1（正中神经）。总的来说,尽管研究之间的运动顺序和诊断标准各不相同,但所有研究都清楚地描述了其测试程序和阳性诊断标准.我们建议对ULTT1进行更标准化的测试程序，包括：1）稳定外展的肩部，2）伸出手腕/手指，3)仰卧前臂，4）外部旋转的肩部，5）延伸的肘部，最后6）通过颈部的侧向弯曲（侧向弯曲）进行结构分化。该提议的测试程序应重现症状，并使临床医生能够评估在紧张或放松神经时症状是否增加/减少。
结论：根据我们的发现，我们提出了一种更标准化的ULTT1测试程序，并伴随阳性诊断标准，以促进未来ULTT诊断准确性研究的同质性。
