next step in diabetic tuning fork vibration not being felt

Test subjects, with eyes closed, would indicate if they perceived the touch of the instrument as either ‘sharp’ or ‘dull’. Standard technique ( 2) was used when applying the monofilaments to the plantar aspects of the 1st and 5th digits. A monofilament terminating in a blunt polyisoprene tip imparting 225 g, ±5% was applied for dull touch. Sharp/Dull Discrimination Test: A sharply cut monofilament imparting 60 g, ±5% was applied for sharp touch. Lack of patient perception at any location was recorded as an abnormal reading. Test subjects would verbally indicate if they perceived vibrations with a ‘yes’ or ‘no’. Lack of an expected response at any location constituted an abnormal reading.īiothesiometer: The biothesiometer was set at the 25-v level and applied to the dorsal aspect of the distal phalanx of the hallux and the dorsal aspect of the 5th metatarsal head. Test subjects, with eyes closed, would verbally indicate perception of the monofilament touch by saying ‘yes’. Monofilaments registering beyond ±5% of the desired 10 g of pressure were not used. SWMT: The accuracy of monofilaments was assessed daily with a digital scale prior to testing. Specific testing protocols were as follows Written informed consent was obtained from all participants in this study.

The study protocol was approved by the institutional review board administered by Portable Ethics IRB of Windham, ME. Comparison between these two groups was then made with regard to vibratory sensation. For the purposes of this study, patients were further subdivided into a diabetic, neuropathic group and a non-diabetic, non-neuropathic group.

Diabetes diagnosis was determined by medical history. Exclusion criteria included foot amputation, open foot ulcers, or foot infection. Criteria included being older than 18 years. TVT values at the hallux and 5th metatarsal head were collected and analyzed.įifty-five patients were recruited on a rolling basis over a 6-month period for participation in the study at the Health Access Network, Lincoln, ME ( Table 1). An integrated timer facilitates performance of timed vibration tests (TVTs), which have been shown to be a valid method of detecting neuropathy ( 12, 13). This device electronically reproduces the same vibration output and decay rate as the traditional tuning fork. Standardization of testing between test subjects and anatomic sites was improved through the use of a novel 128 Hz electronic tuning fork (ETF) ( 11). To test this recommendation, tuning fork testing was performed at the hallux and 5th metatarsal head in diabetic patients with neuropathy (neuropathy diagnosis was established by conventional neurological testing).

Next step in diabetic tuning fork vibration not being felt