The steel ball-bearing test: a new test for evaluating protective sensation in the diabetic foot

Παπάνας, Νικόλαος; Gries, Arnold; Maltezos, Efstratios; Zick, R.

doi:10.1007/s00125-005-0111-5

Cited by 15 publications

(11 citation statements)

References 15 publications

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“…All the studies that evaluated its association with DFU development , active or recently healed DFU , active or past DFU and DFU history achieved statistical significance. In contrast, only one study (out of three) for the prediction of foot ulcer recurrence or re‐ulceration observed an association .…”

Section: Resultsmentioning

confidence: 92%

“…From the 71 included studies, 24 studies evaluated the association of specific variables with DFU development (Table ), 14 studies with DFU recurrence or re‐ulceration (Table ), 15 studies with active or recently healed DFU (Table ), 8 studies with active or past DFU history (Table ) and 10 studies with DFU history (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…We identified 34 studies assessing gender's association with DFU. Only 10 found statistically significant associations: three cohort studies for DFU development, one cohort study for DFU recurrence or re‐ulceration , two cross‐sectional and two case–control studies for active or recently healed DFU, one cross‐sectional study for active or past DFU history and one cross‐sectional study for DFU history . All reported an increased risk for the male gender.…”

Section: Resultsmentioning

confidence: 99%

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Predictive factors for diabetic foot ulceration: a systematic review

Monteiro‐Soares

Boyko

Ribeiro

et al. 2012

Diabetes Metabolism Res

261

242

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Improving ability to predict and prevent diabetic foot ulceration is imperative because of the high personal and financial costs of this complication. We therefore conducted a systematic review in order to identify all studies of factors associated with DFU and assess whether available DFU risk stratification systems incorporate those factors of highest potential value. We performed a search in PubMed for studies published through April 2011 that analysed the association between independent variables and DFU. Articles were selected by two investigators-independently and blind to each other. Divergences were solved by a third investigator. A total of 71 studies were included that evaluated the association between diabetic foot ulceration and more than 100 independent variables. The variables most frequently assessed were age, gender, diabetes duration, BMI, HbA(1c) and neuropathy. Diabetic foot ulceration prevalence varied greatly among studies. The majority of the identified variables were assessed by only two or fewer studies. Diabetic neuropathy, peripheral vascular disease, foot deformity and previous diabetic foot ulceration or lower extremity amputation - which are the most common variables included in risk stratification systems - were consistently associated with diabetic foot ulceration development. Existing diabetic foot ulceration risk stratification systems often include variables shown repeatedly in the literature to be strongly predictive of this outcome. Improvement of these risk classification systems though is impaired because of deficiencies noted, including a great lack of standardization in outcome definition and variable selection and measurement.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Predictive factors for diabetic foot ulceration: a systematic review

Monteiro‐Soares

Boyko

Ribeiro

et al. 2012

Diabetes Metabolism Res

261

242

View full text Add to dashboard Cite

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“…[77] More sophisticated, not widely used alternative tests of protective sensation include the tactile circumferential discriminator [78] and the steel ball-bearing test. [79] Finally, a new simple test measures sweat production by color change of an indicator test applied on the plantar aspect of the foot, thereby additionally evaluating foot skin dryness. [21] In addition, the clinician should meticulously examine the foot for evidence of increased risk.…”

Section: The Diabetic Foot In Renal Failure: Examination and Risk Estmentioning

confidence: 99%

The Diabetic Foot in End Stage Renal Disease

et al. 2007

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Diabetic foot lesions remain a major cause of morbidity in patients with renal failure, especially those on dialysis. Foot complications are encountered at a more than twofold frequency in diabetic patients with end-stage renal disease, and the rate of amputations is 6.5-10 times higher in comparison to the general diabetic population. The causal pathways of the diabetic foot in renal failure are multiple and inter-related. Three major pathologies-neuropathy, ischemia, and infection-are the main contributory factors. Increased awareness of this condition and careful clinical examination are indispensable to avoid serious complications. Appropriate management needs to address all contributory factors. Treatment options include revascularization, off-loading to relieve high-pressure areas, and aggressive control of infection. Equally important is the collaboration between health care providers in a multidisciplinary foot care setting. Moreover, patient education on the measures required to achieve both primary and secondary prevention is of great value. Certainly, technical innovations have made considerable progress possible, but there is a need for further improvement to reduce the number of amputations.

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“…Clinical examination encompassing sensory and motor modalities remains the cornerstone of diagnosis in realworld settings [1,3]. Efforts to improve the diagnosis of DSPN and facilitate larger-scale patient screening have resulted in the development of new tests [3,4], such as the indicator test for sudomotor function (Neuropad [5]), the steel ball-bearing test [6], the automated nerve conduction study of the sural nerve [7,8], VibraTip [9,10], among others.…”

Section: Introductionmentioning

confidence: 99%