Elbow flexion test in the normal population

Rayan, Ghazi M.; Jensen, Christine; Duke, James C.

doi:10.1016/0363-5023(92)90119-a

Cited by 71 publications

(34 citation statements)

References 8 publications

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“…A clinical validity study by Rosati and colleagues 29 evaluated normal subjects performing all four elbow flexion tests described in a study by Rayan and colleagues. 27 In Rayan's study, 3.6% of subjects had a positive test at 1 min and 16.2% were positive at 3 minutes. The authors concluded that sustaining the elbow flexion test for 1 min would reduce the number of false positives in normal individuals.…”

Section: Elbow Flexion Testmentioning

confidence: 99%

“…These researchers found a positive Tinel's sign at the cubital tunnel in 23.5% of 200 elbows of normal subjects, 50% of which were bilateral. 27 Examiner technique may help minimize a false-positive result; for instance, McPherson and Meals advise against vigorous percussion and recommend gentle tapping with the index finger to elicit a Tinel's sign. 17 The aforementioned controversy suggests that the presence of an appropriately performed Tinel's sign may be most useful clinically in combination with other identified findings of nerve compression.…”

Section: Tinel's Signmentioning

confidence: 99%

“…26 Rayan and colleagues examined four different versions of the elbow flexion test on 204 elbows in 102 normal subjects, all of which positioned the elbow in 90 degrees of flexion with different wrist (wrist flexion and extension) and shoulder positions (either neutral or 90 degrees of abduction). 27 Regardless of testing position or length of time the test is sustained, a positive elbow flexion test is considered one which increases the patient's numbness or paresthesias in the ulnar nerve distribution. 28 Reliability and validity studies for the elbow flexion test have been performed using different amounts of time and different upper extremity positions.…”

Section: Elbow Flexion Testmentioning

confidence: 99%

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A Review of Clinical Tests and Signs for the Assessment of Ulnar Neuropathy

Goldman

Brininger

Schrader

et al. 2009

Journal of Hand Therapy

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ABSTRACT:Narrative Review: As part of a comprehensive assessment for suspected ulnar neuropathy, clinical testing plays an important role in the initial identification of a lesion and determining subsequent changes from baseline. The purpose of this article was to review ulnar nerve provocative testing and the substantial collection of diagnostic signs and tests. Administration procedures for each maneuver are described as well as the resulting positive and negative outcomes. The clinical tests described constitute only one aspect of the examination and should not substitute for other key components, such as taking a thorough medical and occupational history. Empirical research studies are indicated to further quantify the relationship between the testing outcomes and the severity of a lesion as well as to determine the most robust motor signs seen in the early stages of the disease.Level of Evidence: 5. J HAND THER. 2009;22:209-20. Clinical testing is an essential component in identifying and determining the extent of pathology for many upper extremity conditions; however, it can be particularly useful for evaluating patients with ulnar neuropathy. Injury to the ulnar nerve often results in a predictable set of upper extremity sensory and motor impairments. Sensory disturbances typically involve the small and ring fingers and can also involve the dorsal-ulnar aspect of the hand if the lesion is proximal to the wrist.1 Sensory changes can contribute to motor control difficulties or even manifest as a safety issue with severe compression to afferent axons transmitting pain and temperature information. Ulnar nerve motor involvement affects most of the intrinsic hand muscles, excluding three muscles in the thenar eminence and the lumbrical muscles to the index and ring fingers. If the entrapment is at the level of the elbow, the flexor digitorum profundus (FDP) to the ring and small fingers and the flexor carpi ulnaris (the strongest wrist flexor) may become weakened.

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Section: Elbow Flexion Testmentioning

confidence: 99%

Section: Tinel's Signmentioning

confidence: 99%

Section: Elbow Flexion Testmentioning

confidence: 99%

See 1 more Smart Citation

A Review of Clinical Tests and Signs for the Assessment of Ulnar Neuropathy

Goldman

Brininger

Schrader

et al. 2009

Journal of Hand Therapy

View full text Add to dashboard Cite

show abstract

“…Tinel sign is positive when percussion of the ulnar nerve at the medial epicondyle reproduces paresthesias in the ring and small fingers. However, nearly 24% of asymptomatic people have this finding [33]. The elbow flexion test also has been used to corroborate the diagnosis of cubital tunnel syndrome.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…The frequency of false positives has been reported with the use of the elbow flexion test and Tinel sign. With the wrist and shoulder in neutral position, Rayan and colleagues [33] showed that 10% of their asymptomatic patients had positive results of the flexion tests. The number of false positives increased when the test was performed with the shoulder abducted and the wrist extended.…”

Section: Clinical Presentationmentioning

confidence: 99%