Reverse Phalen's Test
This test is performed by having the patient maintain full wrist and finger extension for two minutes. The reverse Phalen's test significantly increases pressure in the carpal tunnel within 10 seconds of the change in wrist posture and the carpal tunnel pressure has the tendency to increase throughout the test's duration. In contrast, the change in carpal tunnel pressure noted in the standard Phalen's test is modest and plateaus after 20 to 30 seconds.
The average pressure change for Phalen's test at one and two minutes was only 4 mm Hg. The average pressure changes in the carpal tunnel for the reverse Phalen's test were 34 mm Hg at one minute into the test and 42 mm Hg at the two minute point.
The extended wrist posture significantly changes the pressure within the carpal tunnel and may be more useful as a provocative examination maneuver. Reverse Phalen's maneuver results in a significantly higher intracarpal canal hydrostatic pressure as compared to a traditional Phalen's. This is thought to add to the sensitivity of conventional screening methods.
Read more about this topic: Phalen Maneuver
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