Execution
- 1Position the patient sitting or standing.
- 2Ask the patient to raise both hands over the head.
- 3Ask the patient to maintain the elevated position for at least 3 minutes.
- 4Monitor for symptom reproduction in the median nerve distribution.
- 5Record the time at which symptoms appear.
Positive outcome
Symptoms reproduced in the median nerve distribution in less than 2 minutes are positive. The test is intended to provoke CTS symptoms by sustained hand elevation. Bilateral testing allows quick comparison between sides.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Ahn (2001) | NA | 75.5 | 98.5 | 50.33 | 0.25 |
| Amirfeyz et al. (2005) | NA | 88 | 98 | 44 | 0.12 |
| Ma & Kim (2012) | NA | 86.7 | 88.9 | 7.81 | 0.15 |
CommentHand elevation has promising specificity in several studies, but results still depend on CTS case definition and comparison group. Magee’s positive threshold is symptom reproduction in less than 2 minutes during a 3-minute hold. It is simple and useful clinically, but it should still be interpreted with the whole CTS presentation.
High Clinical Value