Diabetic Neuropathy: Likelihood Ratios

timed

Vibration testing by the timed method was conducted using a 128-Hz tuning fork applied to the same bony prominences bilaterally situated at the dorsum of the first toe. The patient was asked to report the time at which vibration diminished beyond perception. The tuning fork was then applied to the dorsal aspect of the distal phalanx of the examiner's thumb. The time (in seconds) at which vibration sensation diminished beyond the examiner's perception was then recorded on a standardized form.

Study: Diabetes Care. 2001 Feb;24(2):250-6. PMID: 11213874

at great toe

Study: Arch Phys Med Rehabil. 2002 Nov;83(11):1553-8. PMID: 12422324

at ankle. Note that this study also looked at the great toe and obtained values of 96% sensitivity with 75% specificity.

Study: Arch Phys Med Rehabil. 2002 Nov;83(11):1553-8. PMID: 12422324

on-off

Vibration testing by the on-off method was conducted using a 128-Hz tuning fork applied to the bony prominence bilaterally situated at the dorsum of the first toe just proximal to the nail bed. The patient was asked to report the perception of both the start of the vibration sensation and the cessation of vibration on dampening. The testing was conducted twice on each toe, and correct responses were circled on a standardized sheet. The vibration testing threshold was defined as the total number of times the application of the vibrating tuning fork and the dampening of vibration was not felt, with scores varying between 0 and 8.

Study: Diabetes Care. 2001 Feb;24(2):250-6. PMID: 11213874

Romberg testing was performed by having

the subject stand with the feet close together but not

touching. Initially, the subjects stood with eyes open for about

10 seconds; subjects then closed their eyes. The ability to stand

without opening the eyes or taking a step for 30 seconds was

considered a negative or normal test.

Study: Arch Phys Med Rehabil. 2002 Nov;83(11):1553-8. PMID: 12422324