All Upper Limb Tension Tests | ULTT | ULNT
Upper Limb Tension Tests Explained
Overview of Upper Limb Tension Tests
- The video discusses various forms of the Upper Limb Tension Test (ULTT), which assess neurological structures in the upper limbs, similar to how the Straight Leg Raise Test evaluates lower limb nerves.
- According to Wainner et al. (2003), ULTT1 (or ULTT A) has a sensitivity of 97% and specificity of 22% for diagnosing cervical radiculopathy.
Performing ULTT1 (ULTT A)
- To perform ULTT1, depress the patient's shoulder, abduct their arm to 110 degrees, and flex the elbow to 90 degrees. Then laterally rotate the shoulder, extend the wrist and fingers, and slowly extend the elbow until symptoms arise.
- Confirm stress on neurological structures by slightly flexing the elbow and asking the patient to laterally flex their neck in the opposite direction; this should increase tension again.
Performing ULTT2 (ULTT B)
- The procedure for ULTT2 is similar to ULTT1 but involves depressing the shoulder with your hip, abducting the arm only 10 degrees, supinating the forearm, extending fingers and wrist before slowly extending the elbow until symptoms are provoked.
- As with ULTT1, confirm findings by creating slack through elbow flexion followed by lateral neck flexion in the opposite direction.
Performing ULTT3 (ULTT C)
- For ULTT3 targeting radial nerve stress: depress shoulder with your hip, bring arm into 10 degrees abduction, flex elbow at 90 degrees, pronate forearm while flexing fingers before fully extending elbow until symptoms appear.
- Again confirm findings by having patients laterally flex their neck in opposition after provoking symptoms.
Performing ULTT4 (ULTT D)
- In performing ULTT4 for ulnar nerve stress: first depress shoulder then position arm at 90 degrees abduction; pronate forearm while extending fingers/wrist before bringing fingers towards ear until symptoms are provoked.
- Symptoms can also be aggravated by having patients flex their neck towards that side or extending their elbow afterward for further confirmation of nerve stress.
Conclusion on Testing
- All tests are considered positive if they reproduce patient symptoms or show marked mobility decrease compared to other side assessments. This concludes an overview of Upper Limb Tension Tests relevant for diagnosing conditions like cervical radiculopathy.