Early Physiotherapeutic Assessment Through Specific Orthopedic Tests in Patients with Suspected Carpal Tunnel Syndrome: A Systematic Review
DOI:
https://doi.org/10.70577/asce.v5i3.1084Keywords:
carpal tunnel syndrome, orthopedic tests, diagnostic accuracy, physiotherapeutic assessment, systematic reviewAbstract
Carpal tunnel syndrome represents the most prevalent peripheral entrapment neuropathy of the upper limb, so early physiotherapeutic assessment through specific orthopedic tests constitutes a fundamental pillar in initial identification, although their individual diagnostic accuracy remains controversial in the current scientific literature.
The objective of this systematic review was to synthesize available scientific evidence regarding the diagnostic utility of specific orthopedic tests during early physiotherapeutic assessment of patients with suspected carpal tunnel syndrome, using international methodological standards for diagnostic accuracy reviews.
A diagnostic accuracy systematic review was conducted according to PRISMA 2020 guidelines through an exhaustive search in PubMed, Scopus, SciELO, and DiTA, including studies published between 2015 and July 2026 that evaluated the diagnostic accuracy of tests such as Phalen, Tinel, and Durkan against nerve conduction studies or ultrasonography.
Twelve studies were included with approximately 2,274 evaluated extremities, finding that no single test exhibited simultaneous sensitivity and specificity above 85%, whereas combined tests improved diagnostic performance up to sensitivities of 94.1% and specificities of 100%.
It is concluded that no isolated clinical maneuver possesses sufficient accuracy to independently confirm or rule out carpal tunnel syndrome, so the combined application of a battery of provocative tests, complemented with functional and sensory evaluation, optimizes early detection and strengthens evidence-based clinical decision-making.
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