Normative data for cutaneous threshold and spatial discrimination in the feet

Abstract

This study provides age-related normative values for foot sensation to help clinicians assess sensory deficits in relation to aging and identify patients with underlying nerve problems. Muscle Nerve 56: 399-407, 2017.

Development of grading scales of pedal sensory loss using Mokken scale analysis on the Rotterdam Diabetic Foot Study Test Battery data

“…Decline in foot sensation due to age was confirmed in our analysis, with age being the most important determinant . Only nonsignificant differences were observed between genders, which is in line with previous reports . The observed association between weight and foot sensation is presumably confounded by (components of) the metabolic syndrome, as it relates to polyneuropathy, and should be investigated in future studies .…”

Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery

“…This scoring system contains dichotomized items on static‐ and moving 2‐point discrimination (S2PD and M2PD), static 1‐point discrimination (S1PD), vibration sense, cold stimulus tests, Romberg's test, experienced numbness, prior diabetic foot ulcer and prior amputation. S2PD and M2PD were tested with a Disk‐Criminator™ (US Neurologicals, LCC, Poulsbo, WA), with the threshold set at 8 mm (abnormal: > 8 mm), based on previously published normative values . S1PD was tested with a 10 g Semmes‐Weinstein monofilament (Baseline® Tactile™, Minneapolis, MN), based on current international standards of medical care in diabetes .…”

“…The trait score can be calculated after a patient has responded to the items of the battery, to estimate their position along the underlying trait (ability). Findings in healthy volunteers without known neuropathy have been published separately and are presented in this study for comparative purposes …”

Predicting ulcer‐free survival using the discriminative value of screening test locations

“…Moreover, testing is often suggested on areas with excessive callus (eg, metatarsal heads), which lowers validity and results in greater intertest and intratest reliability . From a previous study, we recommend the use of test sites with less callus formation, like hallux, fifth toe, medial heel, first dorsal web, and lateral foot to get a true estimate of foot sensation . The current prospective study adds that screening on a multitude of locations does not result in a more accurate risk estimation.…”

“…Protective sensation was measured with monofilaments (Baseline Tactile, USA) on five sites per foot: hallux, medial heel, first dorsal web, lateral foot, and fifth toe, The test sites were chosen in line with the nerve distribution of the foot: (a) hallux (medial plantar nerve [tibial nerve]), (b) medial heel (calcaneal nerve [tibial nerve]), (c) first dorsal web (deep peroneal nerve), (d) lateral foot (sural nerve), and (e) fifth toe (lateral planter nerve [tibial nerve]) . Vibration sense (Rydel‐Seiffer tuning fork (Martin, Tuttlingen, Germany)) was tested on both halluces and medial malleoli and compared with normative values . Scores were dichotomised per test location (ie, 1, not feeling the stimulus [aberrant] or 0, feeling the stimulus [nonaberrant]).…”