Test‐retest and time dependent variation and diagnostic values of vibratory sensation determined by biothesiometer and the Rydel‐Seiffer tuning fork

Abstract

Background and aims: Polyneuropathy is a common neurological disorder with many potential causes. An essential part in screening, diagnosis, and follow-up evaluation of polyneuropathy is testing of the sensory function including vibratory sensation. The graduated Rydel-Seiffer tuning fork and the biothesiometer have been developed to quantify vibratory sensation through detection thresholds. The aim of this study is to compare the vibration detection thresholds determined by the two instruments regarding intraindividual temporal changes, interindividual variation in healthy subjects and comparison of the diagnostic value in patients with a clinical suspicion of polyneuropathy.Methods: Ninety-four healthy subjects, 98 patients with and 97 patients without a diagnosis of polyneuropathy were included. Quantitative sensory testing including biothesiometry, structured clinical examination, and nerve conduction studies were performed three times during 52 weeks in healthy subjects and once in patients.Results: There were no significant changes over time for neither the Rydel-Seiffer tuning fork nor the biothesiometer, and both had larger between-subject variation than within-subject variation. Relative intertrial variability was largest for the biothesiometer. Diagnostic value (sensitivity, specificity, positive predictive value, and negative predictive value) was moderate for both methods (Rydel-Seiffer tuning fork: 58%, 74%, 70%, 64%; biothesiometer: 47%, 77%, 68%, 59%). Interpretation:The Rydel-Seiffer tuning fork and the biothesiometer have a low testretest and time dependent variation. They perform almost equally as diagnostic tools in patients with suspected polyneuropathy with a tendency toward better performance of the tuning fork.

Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients

“…In our case, the differences were found in results between neurothesiometer and diapason measures: we observed a closer relationship between altered gait parameters and sensory vibration loss measured by the neurothesiometer in bivariate analysis. A recent study 68 concluded that there was no difference between the Rydel‐Seiffer diapason and the neurothesiometer in the polyneuropathy diagnosis for both clinical and research purposes, although diabetic patients were not included in this research. Of all the sensory variables considered in our study, ‘the presence of sensory neuropathy,’ established by the combination of monofilament and VPT by neurothesiometer, was the variable that was related to the most gait abnormalities, which reinforces the importance of both deep sensory modalities during walking.…”

Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life

“…The weakest vibration intensity the patient was able to perceive was recorded. Vibratory sensation was considered deficient when the participant was unable to perceive the stimulus at 25 volts or more on the dorsal area of the big toe [ 67 , 77 , 78 , 79 , 80 , 81 ].…”

The Role of Quantitative Sensory Testing in Clinical Medicine and Research

“…Voltage is subsequently increased or decreased according to a protocol, and the subject reports their perceptions [31]. Vibrational QST has been shown to perform comparably but not better than the Rydel-Seiffer tuning fork (used in neurologic physical examination) in predicting the detection of neuropathy [32]. Therefore, the tuning fork, the simpler method, may be preferred [16].…”