Measuring vibration sensations with graduated tuning fork. Simple and reliable means to detect diabetic patients at risk of neuropathic foot ulceration.

Full Abstract

To find a simple and reliable means to measure vibration sensations, 189 diabetic patients and 88 control subjects were tested at different sites with a graduated tuning fork. Within-test variation at big toes reached 8.4% in diabetic patients vs. 2.2% in control subjects. Mean contralateral variation was 7.5% in diabetic patients vs. 2.5% in control subjects. Tuning-fork sensations were inversely correlated with duration of diabetes, whereas no correlation was found with HBA1c levels or the severity of retinopathy. Ninety-nine (52%) patients had vibratory sensation at big toes of less than 99th percentile of normal values for age. In addition, 51% of the patients with clinical symptoms at extremities (n = 67), 70% of the patients without tendon reflexes (n = 50), and 75% of the patients with abnormal nerve conduction velocities (n = 60) also had low vibration sensations. All patients with lower-limb injuries (n = 7) had values at big toes of less than 2. Altogether, the graduated tuning fork represents a simple and reliable alternative to quantitate vibration sensations. Long-term follow-up of asymptomatic patients will indicate whether these abnormalities reflect underlying neuropathy. Patients with abnormal values at screening will necessitate additional investigations and special foot-care education programs.

Author information

Author/s: Thivolet, C (C); el Farkh, J (J); Petiot, A (A); Simonet, C (C); Tourniaire, J (J);

Affiliation: Endocrinology Branch, Antiquaille Hospital, Lyon, France.

Journal and publication information

Publication Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial

Journal: Diabetes care (Diabetes Care), published in UNITED STATES. (Language: eng)

Reference: 1990-Oct; vol 13 (issue 10) : pp 1077-80

Dates: Created 1990/11/21; Completed 1990/11/21; Revised 2007/11/15;

PMID: 2209306, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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