Elvey Test

 Elvey Test

What is Elvey Test?

Elvey test (also known as upper limb tension test or brachioplexus tension test) is used mainly to check for cervical spine radiculopathy.

The nerve roots supplying the upper extremity are provoked by stretching them utilizing position changes of the shoulder, elbow, and wrist.


How it’s Performed?

The upper limb tension test, or brachial plexus tension tests, involve an ordered sequence of movement of the shoulder girdle, arm, elbow, forearm, wrist, and hand.

The tests as described by Elvey are divided into four examination segments:

Elvey Test 1 (Median nerve):

Several studies have shown that the longitudinal motion of the median nerve is affected by motion of the fingers and wrist, with digital flexion resulting in a proximal slide into the forearm, and wrist and finger extension both producing a distal slide of the nerve toward the hand. Hyperextension of the wrist has been shown to cause the median nerve to slide 10–15 mm distally relative to a fixed bony landmark in the carpal tunnel whereas flexion of the wrist and fingers moves the nerve 4 mm proximally.

Elvey Test 2 (Musculocutaneous, Axillary nerves):

Elvey Test 3 (Radial nerve):

Elvey Test 4 (Ulnar nerve, C8 and T1 nerve roots):

What does a positive Elvey Test mean?

Sensitivity & Specificity

A systematic review 1 of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy found that the upper limb tension test (ULTT) demonstrated high sensitivity and low specificity ranging from:

Notes

See Also: Lasègue test

Reference

  1. Sidney M. Rubinstein,corresponding author Jan J. M. Pool,1 Maurits W. van Tulder, Ingrid I. Riphagen, and Henrica C. W. de Vet. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy.Eur Spine J. 2007 Mar; 16(3): 307–319. PMID: 17013656.
  2. Elvey RL: Brachial plexus tension tests and the pathoanatomical origin of arm pain. In: Glasgow EF, Twomey LT, eds. Aspects of Manipulative Therapy. Melbourne, Victoria: Australia, Lincoln Institute of Health Sciences, 1979:105–110.
  3. Kenneally M, Rubenach H, Elvey R: The upper limb tension test: the SLR of the arm. In: Grant R, ed. Physical Therapy of the Cervical and Thoracic Spine. New York, NY: Churchill Livingstone, 1988. INTERVENTION 420.
  4. Clinical Tests for the Musculoskeletal System 3rd Edition.
  5. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.

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