THE TUNING FORK REVISITED

被引:91
作者
LINIGER, C
ALBEANU, A
BLOISE, D
ASSAL, JP
机构
[1] Diabetes Treatment and Teaching Unit, University Hospital, Geneva
关键词
Foot ulceration; Neuropathy; Preventive care; Rydel‐Seiffer; tuning fork; Vibration sensation;
D O I
10.1111/j.1464-5491.1990.tb01319.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The performance of the Rydel‐Seiffer graduated tuning fork was examined in healthy subjects and in various groups of diabetic patients in order to evaluate its efficacy for identifying patients whose loss of vibration sensation may expose them to the risk of foot injury. Vibration perception score measured with the tuning fork declined with age (p < 0.001) in the control subjects. It correlated well (r = −0.90, p < 0.001) with the thresholds obtained with an electromagnetic instrument (Vibrameter) in diabetic patients, in whom vibration perception score was impaired compared with control subjects (4.0 ± 1.8 (± SD) vs 5.4 ± 1.4, p < 0.001). Age‐related Rydel‐Seiffer tuning fork vibration sensation was impaired in 79% of 38 ulcerated feet of 26 patients. The tuning fork score was 4.0 in 95% of the ulcerated feet. We conclude that the Rydel‐Seiffer graduated tuning fork is a suitable tool for screening for sensation loss and that diabetic patients with a tuning‐fork score of 4.0 are vulnerable to ulceration. 1990 Diabetes UK
引用
收藏
页码:859 / 864
页数:6
相关论文
共 22 条
[1]  
Boulton AJM, Hardisty CA, Betts RP, Et al., Dynamic foot pressure and other studies as diagnostic and management aids in diabetic neuropathy, Diabetes Care, 6, pp. 26-33, (1983)
[2]  
Boulton AJM, Kubrusly DB, Bowker JH, Et al., Impaired vibratory perception and diabetic foot ulceration, Diabetic Med, 3, pp. 335-337, (1986)
[3]  
Guy RJC, Clark CA, Malcolm PN, Watkins PJ, Evaluation of thermal and vibration sensation in diabetic neuropathy, Diabetologia, 28, pp. 131-137, (1985)
[4]  
Bild DE, Selby JV, Sinnock P., Browner WS, Braveman P., Showstack JA, Lower‐extremity amputation in people with diabetes: Epidemiology and prevention, Diabetes Care, 12, pp. 24-31, (1989)
[5]  
Maser RE, Nielsen VK, Bass EB, Et al., Measuring diabetic neuropathy: Assessment and comparison of clinical examination and quantitative sensory testing, Diabetes Care, 12, pp. 270-275, (1989)
[6]  
Rydel A., Seiffer W., Untersuchungen über das Vibrationsgefühl oder die sog. ‘Knochensensibilität’ (Pallästhesie), Arch Psychiatr Nervenkr, 37, pp. 488-536, (1903)
[7]  
Goldberg JM, Lindblom U., Standardized method of determining vibratory perception thresholds for diagnosis and screening in neurological investigation, J Neurol Neurosurg Psychiatry, 42, pp. 793-803, (1979)
[8]  
Liniger C., Pernet A., Moody JF, Assal, Effect of gangliosides on diabetic peripheral neuropathy, Diabetes Res Clin Pract, 7, pp. 251-258, (1989)
[9]  
Crausaz F., Clavel S., Liniger C., Albeanu A., Assal, Additional factors associated with plantar ulcers in diabetic neuropathy, Diabetic Med, 5, pp. 771-775, (1988)
[10]  
Bland M., An Introduction to Medical Statistics, (1987)