# CORRELATION BETWEEN CONTROLLED-PRESSURE PROVOCATIVE TEST DURATION AND ELECTRODIAGNOSTIC SEVERITY IN CARPAL TUNNEL SYNDROME

## TL;DR

This study found no link between how long it takes for symptoms to appear during a wrist pressure test and the severity of carpal tunnel syndrome as measured by nerve tests.

## Contribution

The study is the first to show that controlled-pressure provocative test duration does not correlate with electrodiagnostic severity in carpal tunnel syndrome.

## Key findings

- No correlation was found between test duration and electrodiagnostic severity (ρ = –0.16, p = 0.074).
- The time to symptom provocation during the controlled-pressure test was not a reliable indicator of nerve damage severity.

## Abstract

To assess the correlation between controlled-pressure provocative test duration and electrodiagnostic severity in carpal tunnel syndrome.

Cross-sectional correlational study.

Patients with clinical symptoms consistent with carpal tunnel syndrome were recruited from the electrodiagnosis clinic of the Department of Rehabilitation Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, between September 2023 and July 2024.

Patients underwent electrodiagnostic studies, and the severity of carpal tunnel syndrome was classified as mild, moderate, or severe according to the 2011 criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM). Each participant subsequently received a controlled-pressure provocative test. The time to symptom provocation was recorded, with a maximum duration of 30 s. Spearman’s rank correlation was used to assess the association between test duration and electrodiagnostic severity.

In 124 hands, 31, 45, and 48 hands were categorized by the degree of electrodiagnostic severity as mild, moderate and severe, respectively. There was no correlation (ρ = –0.16, p-value = 0.074) between controlled-pressure provocative test duration and electrodiagnostic severity.

There was no correlation between controlled-pressure provocative test duration and electrodiagnostic severity in patient with carpal tunnel syndrome.

Carpal tunnel syndrome is a condition in which the median nerve in the wrist is compressed, causing symptoms like numbness and tingling. This study investigated whether the time it takes for provoked symptoms during a controlled-pressure Carpal Compression Test is related to the severity of nerve damage, classified by electrodiagnosis study in 124 hands. The results showed no significant relationship between the time to symptom appearance and the severity of carpal tunnel syndrome. These findings suggest that the duration of the wrist pressure test may not be a reliable indicator of the severity of nerve damage in carpal tunnel syndrome.