The pronator syndrome. An evaluation of dynamic maneuvers for improving electrodiagnostic sensitivity

The role of three test maneuvers (elbow flexion, forearm pronation and finger flexion against resistance) in improving sensitivity of conventional nerve conduction studies used in cases of suspected pronator teres syndrome were evaluated in 11 healthy control subjects and 10 patients with the clinical diagnosis of pronator teres syndrome. Stimulation of the median nerve was performed above and below the elbow before exercise and immediately after the test maneuvers; the resultant median motor and sensory responses were recorded. Before and after exercise, median motor and sensory responses (e.g., amplitude, latency, velocity) did not differ significantly between the two groups; only one patient with suspected pronator teres syndrome developed sensory amplitude changes after exercise. We concluded that these test maneuvers did not significantly improve the sensitivity of conventional nerve conduction studies in the diagnosis of pronator teres syndrome.