DIAGNOSTIC ACCURACY OF THE MODIFIED PHALEN TEST COMPARED TO OTHER CLINICAL MANEUVERS IN CARPAL TUNNEL SYNDROME: A CROSS-SECTIONAL STUDY
Abstract
https://doi.org/10.31386/dmj.2025.19.2.6
Background: Carpal Tunnel Syndrome is one of the most common upper limb compression neuropathies with several tests/signs used for the assessment in clinical diagnosis. This study aimed to assess the effectiveness of the Modified Phalen test in the diagnosis of Carpal Tunnel Syndrome compared to other tests and electrodiagnostic studies.
Methodology: A cross-sectional diagnostic accuracy study was conducted to assess the effectiveness/validity and accuracy of the Modified Phalen test for the diagnosis of Carpal Tunnel Syndrome and compare it to the other available signs/tests. It took 5 months to enroll a total of 100 cases, i.e. hands. The validity, strength of association, and accuracy were assessed using SPSS version 26.
Results: Tinel’s sign P <0.001, Durkan test P = 0.006, and Modified Phalen Test P = 0.027, with very strong and strong correlation; Phi = 0.387, 0.275 and 0.222, while Phalen test was not significant, P = 0.086 and Phi = 0.172. The modified Phalen test showed an accuracy of 78% second to the Durkan test's 81% and had a sensitivity of 85.7% higher than Tinel’s sign of 52.4% and the Phalen test's 60.7%, and lower than the Durkan test's 89.3%.
Conclusion: The modified Phalen Test shows moderate diagnostic utility with good sensitivity but poor specificity, suggesting its use may be helpful in screening but not confirmation of Carpal Tunnel Syndrome.
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