Comparative Analysis of the Predictive Values of Phalen’s and Carpal Compression Tests in Diagnosis and Management of the Carpal Tunnel Syndrome Patients based on Electrodiagnostic Testing

Carpal tunnel syndrome (CTS) has been known as a common neuropathy leading to hand dysfunction. Although several diagnostic tools are available, but there is still a matter of debate on early diagnosis of CTS using Phalen’s and carpal compression tests. Thus, the present study was conducted to comparatively examine the predictive values of the mentioned tests in diagnosis and management of the CTS patients based on the results of electrodiagnostic tests.

A number of 45 patients with confirmed CTS and 33 healthy subjects who referred to Hazrat Rasul Akram and Firouzgar hospitals in Tehran city were enrolled in this study. All the participants were underwent Phalen’s and compression tests. Furthermore, the clinical history of the patients was retrieved from institutional databases. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were determined for each test. Data analysis was done using SPSS version 24.

Thirty-seven (82.2%) out of 45 CTS patients were females and 8 (17.8%) were males. The sensitivity, specificity, PPV and NPV for Phalen’s test was determined 75.6, 72.7, 79.1 and 68.6%, and for carpal compression test was obtained to be 93.3, 87.9, 93.1 and 90.6 %. Moreover, the results showed that the median sensory nerve action potential delayed significantly (p < 0.001) in patients who identified as CTS by Phalen’s and compression tests compared to non-CTS individuals.

According to the results, the carpal compression test has superior predictive values in diagnosis of CTS compared to Phalen’s test. However, further studies should be adjusted for various confounders including the age, sex, comorbidities, grade of the CTS, and etc. to obtain clear and conclusive results.