advertising
-
1.
American Diabetes Association: Standards of medical care in diabetes: 2011. Diabetes Care 34 (suppl 1): S11, 2011.
-
2.
Young MJ, Boulton AJ, MacLeod AF, et al: A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 36: 150, 1993.
-
3.
Tesfaye S, Tesfaye S, Boulton AJ, et al: Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 33: 2285, 2010.
-
4.
Boulton AJ, Armstrong DG, Albert SF, et al: Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care 31: 1679, 2008.
-
5.
Li Y, Burrows NR, Gregg EW, et al: Declining rates of hospitalization for nontraumatic lower-extremity amputation in the diabetic population aged 40 years or older: U.S., 1988–2008. Diabetes Care 35: 273, 2012.
-
6.
Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, et al: The global burden of diabetic foot disease. Lancet 366: 1719, 2005.
-
7.
Jeffcoate WJ, van Houtum WH: Amputation as a marker of the quality of foot care in diabetes. Diabetologia 47: 2051, 2004.
-
8.
The LEA Study Group: Comparing the incidence of lower extremity amputations across the world: the Global Lower Extremity Amputation Study. Diabet Med 12: 14, 1995.
-
9.
Gin H, Rigalleau V, Baillet L, et al: Comparison between monofilament, tuning fork and vibration perception tests for screening patients at risk of foot complication. Diabetes Metab 28: 457, 2002.
-
10.
Olaleye D, Perkins BA, Bril V: Evaluation of three screening tests and a risk assessment model for diagnosing peripheral neuropathy in the diabetes clinic. Diabetes Res Clin Pract 54: 115, 2001.
-
11.
Richard JL, Reilhes L, Burvey S, et al: Screening patients at risk for diabetic foot ulceration: a comparison between measurement of vibration perception threshold and 10-g monofilament test. Int Wound J [Published online ahead of print August 14, 2012; doi: ].
-
12.
Campbell WW, DeJong RN, Haerer AF: “The Exteroceptive Sensations,” in DeJong's The Neurologic Examination, 6th Ed, p 436, Lippincott Williams & Wilkins, PA, 2005.
-
13.
Yong R, Karas TJ, Smith KD, et al: The durability of the Semmes-Weinstein 5.07 monofilament. J Foot Ankle Surg 39: 34, 2000.
-
14.
Dros J, Wewerinke A, Bindels PJ, et al: Accuracy of monofilament testing to diagnose peripheral neuropathy: a systematic review. Ann Fam Med 7: 555, 2009.
-
15.
Bell-Krotoski JA, Buford WL: The force/time relationship of clinically used sensory testing instruments. J Hand Ther 10: 297, 1997.
-
16.
McGill M, Molyneaux L, Yue DK: Use of the Semmes-Weinstein 5.07/10 gram monofilament: the long and the short of it. Diabet Med 15: 615, 1998.
-
17.
McGill M, Molyneaux L, Spencer R, et al: Possible sources of discrepancies in the use of the Semmes-Weinstein monofilament: impact on prevalence of insensate foot and workload requirements. Diabetes Care 22: 598, 1999.
-
18.
Lavery LA, Lavery DE, Lavery DC, et al: Accuracy and durability of Semmes-Weinstein monofilaments: what is the useful service life? Diabetes Res Clin Pract 97: 399, 2012.
-
19.
Meijer JW, Smit AJ, Lefrandt JD, et al: Back to basics in diagnosing diabetic polyneuropathy with the tuning fork! Diabetes Care 28: 2201, 2005.
-
20.
Oyer DS, Saxon D, Shah A: Quantitative assessment of diabetic peripheral neuropathy with the clanging tuning fork test. Endocr Pract 13: 5, 2007.
-
21.
O'Neill J, McCann SM, Lagan KM: Tuning fork (128 Hz) versus neurothesiometer: a comparison of methods of assessing vibration sensation in patients with diabetes mellitus. Int J Clin Pract 60: 174, 2006.
-
22.
Cornblath DR: Diabetic neuropathy: diagnostic methods. Adv Stud Med 4: S650, 2004.
-
23.
Botez SA, Liu G, Logigian E, et al: Is the bedside timed vibration test reliable? Muscle Nerve 39: 221, 2009.
-
24.
Perkins BA, Olaleye D, Zinman B, et al: Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care 24: 250, 2001.
-
25.
Bloom S, Till S, Sonksen P, et al: Use of a biothesiometer to measure individual vibration thresholds and their variation in 519 non-diabetic subjects. Br Med J (Clin Res Ed) 288: 1793, 1984.
-
26.
Thomson FJ, Masson EA, Boulton AJ: Quantitative vibration perception testing in elderly people: an assessment of variability. Age Ageing 21: 171, 1992.
-
27.
Gin H, Baudoin R, Raffaitin CH, et al: Non-invasive and quantitative assessment of sudomotor function for peripheral diabetic neuropathy evaluation. Diabetes Metab 37: 527, 2011.
An Initial Evaluation of a Proof-of-Concept 128-Hz Electronic Tuning Fork in the Detection of Peripheral Neuropathy
Search for other papers by Todd O'Brien in
Current site
Google Scholar
PubMed
Search for other papers by Joseph Karem in
Current site
Google Scholar
PubMed
Background
Diabetic peripheral neuropathy (DPN) is an essential precursor leading to diabetic limb loss. Neurologic screening tests, including the 128-Hz tuning fork (TF), have long been used to identify and track the progression of DPN, thereby guiding the implementation of preventive strategies. Although a sensitive indicator of neuropathy, shortcomings of TF testing include the lack of standardization and quantification of clinical findings. In an attempt to overcome these limitations, a novel 128-Hz electronic TF (ETF) prototype has been developed that is capable of performing accurate timed vibration tests (TVTs). This study was designed to assess the ability of the ETF to detect sensory impairment compared with three established neurologic screening methods: the Semmes-Weinstein monofilament test, the biothesiometer, and the sharp/dull discrimination test.
Methods
Fifty-five test patients were recruited from the primary author's practice and enrolled according to an approved protocol. The 10-g Semmes-Weinstein monofilament test and the sharp/dull discrimination test were administered in standard fashion to the plantar aspects of digits 1 and 5 bilaterally. The ETF and the biothesiometer (25-V setting) were applied to the dorsal aspects of the distal phalanx of the hallux and fifth metatarsal head bilaterally.
Results
The sensitivity and specificity of neuropathy detection for the ETF were 0.953 and 0.761, respectively, using conventional tests as reference standards.
Conclusions
Performance of TVTs with the ETF detected sensory impairment compared with three conventional neurologic screening methods. Given these findings, the ETF could facilitate the use of standardized TVTs as an indicator of DPN progression.
advertising
