Skip to main content
Top
Published in: Diabetologia 11/2007

01-11-2007 | Article

Vibrotactile threshold measurement for detecting peripheral neuropathy: defining variability and a normal range for clinical and research use

Authors: J. Duke, M. McEvoy, D. Sibbritt, M. Guest, W. Smith, J. Attia

Published in: Diabetologia | Issue 11/2007

Login to get access

Abstract

Aims/hypothesis

We aimed to define normal ranges for vibration sense as measured by vibratory perception thresholds (VPTs) using biothesiometry.

Methods

We performed biothesiometry in a community-dwelling sample of 901 people aged 55 to 85 years who did not have diabetes. We quantitated the variation between repeat measures using analysis of variance and Bland–Altman plots. We also plotted the age- and sex-specific reference ranges.

Results

We found small but statistically significant differences between repeat measures using the ascending and descending method of limits. Statistically higher vibration thresholds were noted on the right arm and leg compared with the left. Significantly higher vibration thresholds were also seen in men vs women for both lower limbs. We also defined sex-specific reference intervals (normal ranges) for biothesiometry for older persons and quantitated the increase in vibration threshold with increasing age.

Conclusions/interpretation

For reliability, it may be sufficient to obtain the average of two ascending measures separated by at least 1 min in just the right hand or right foot, since this is usually the one with the higher threshold. Although identical reference ranges can be used for men and women for the upper limb, there are significant differences in the lower limbs. The major determinant of VPT is age: we have established age-specific norms for VPT testing for adults between 55 and 85 years of age.
Literature
1.
2.
go back to reference Nasterlack M, Dietz MC, Frank KH et al (1999) A multidisciplinary cross-sectional study on solvent-related health effects in painters compared with construction workers. Int Arch Occup Environ Health 72:205–214CrossRefPubMed Nasterlack M, Dietz MC, Frank KH et al (1999) A multidisciplinary cross-sectional study on solvent-related health effects in painters compared with construction workers. Int Arch Occup Environ Health 72:205–214CrossRefPubMed
3.
go back to reference Broadwell DK, Darcey DJ, Hudnell HK, Otto DA, Boyes WK (1995) Work-site clinical and neurobehavioral assessment of solvent-exposed microelectronics workers. Am J Ind Med 27:677–698CrossRefPubMed Broadwell DK, Darcey DJ, Hudnell HK, Otto DA, Boyes WK (1995) Work-site clinical and neurobehavioral assessment of solvent-exposed microelectronics workers. Am J Ind Med 27:677–698CrossRefPubMed
6.
go back to reference Tapp RJ, Shaw JE, de Courten MP, Dunstan DW, Welborn TA, Zimmet PZ, AusDiab Study Group (2003) Foot complications in Type 2 diabetes: an Australian population-based study. Diabetic Med 20:105–113CrossRefPubMed Tapp RJ, Shaw JE, de Courten MP, Dunstan DW, Welborn TA, Zimmet PZ, AusDiab Study Group (2003) Foot complications in Type 2 diabetes: an Australian population-based study. Diabetic Med 20:105–113CrossRefPubMed
7.
go back to reference Mayfield JA, Sugarman JR (2000) The use of the Semmes–Weinstein monofilament and other threshold tests for preventing foot ulceration and amputation in persons with diabetes. J Fam Pract 49(11 Suppl):S17–S29PubMed Mayfield JA, Sugarman JR (2000) The use of the Semmes–Weinstein monofilament and other threshold tests for preventing foot ulceration and amputation in persons with diabetes. J Fam Pract 49(11 Suppl):S17–S29PubMed
8.
go back to reference Adler AI, Boyko EJ, Ahroni JH, Stensel V, Forsberg RC, Smith DG (1997) Risk factors for diabetic peripheral sensory neuropathy. Results of the Seattle prospective diabetic foot study. Diabetes Care 20:1162–1167CrossRefPubMed Adler AI, Boyko EJ, Ahroni JH, Stensel V, Forsberg RC, Smith DG (1997) Risk factors for diabetic peripheral sensory neuropathy. Results of the Seattle prospective diabetic foot study. Diabetes Care 20:1162–1167CrossRefPubMed
9.
go back to reference Moody L, Arezzo J, Otto D (1986) Screening occupational populations for asymptomatic or early peripheral neuropathy. J Occup Med 28:975–986CrossRefPubMed Moody L, Arezzo J, Otto D (1986) Screening occupational populations for asymptomatic or early peripheral neuropathy. J Occup Med 28:975–986CrossRefPubMed
10.
go back to reference Gerr F, Hershman D, Letz R (1990) Vibrotactile threshold measurement for detecting neurotoxicity: reliability and determination of age- and height-standardized normative values. Arch Environ Health 45:148–154CrossRefPubMed Gerr F, Hershman D, Letz R (1990) Vibrotactile threshold measurement for detecting neurotoxicity: reliability and determination of age- and height-standardized normative values. Arch Environ Health 45:148–154CrossRefPubMed
11.
go back to reference Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A (2000) Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care 23:606–611CrossRefPubMed Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A (2000) Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care 23:606–611CrossRefPubMed
12.
go back to reference Dillman DA (1978). Mail and telephone surveys: the total design method. Wiley, New York Dillman DA (1978). Mail and telephone surveys: the total design method. Wiley, New York
13.
go back to reference Ware JE, Sherbourne CD (1992) The MOS 36-item short form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed Ware JE, Sherbourne CD (1992) The MOS 36-item short form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed
14.
go back to reference Washburn RA, Smith KW, Jette AM et al (1993) The physical activity scale for the elderly (PASE): Development and evaluation. J Clin Epidemiol 46:153–162CrossRefPubMed Washburn RA, Smith KW, Jette AM et al (1993) The physical activity scale for the elderly (PASE): Development and evaluation. J Clin Epidemiol 46:153–162CrossRefPubMed
15.
go back to reference Washburn RA, McAuley E, Katula J et al (1999) The physical activity scale for the elderly (PASE); Evidence for validity. J Clin Epidemiol 52:643–651CrossRefPubMed Washburn RA, McAuley E, Katula J et al (1999) The physical activity scale for the elderly (PASE); Evidence for validity. J Clin Epidemiol 52:643–651CrossRefPubMed
17.
go back to reference Andrews G, Slade T (2001) Interpreting scores on the Kessler psychological distress scale (K10). Aust N Z J Public Health 25:494–497CrossRefPubMed Andrews G, Slade T (2001) Interpreting scores on the Kessler psychological distress scale (K10). Aust N Z J Public Health 25:494–497CrossRefPubMed
18.
go back to reference Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRef Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRef
19.
go back to reference Weissman MM, Sholomskas D, Pottenger M et al (1977) Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 106:203–214CrossRefPubMed Weissman MM, Sholomskas D, Pottenger M et al (1977) Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 106:203–214CrossRefPubMed
20.
go back to reference Crook TH, Feher EP, Larrabee GJ (1992) Assessment of memory complaint in age-associated memory impairment: the MAC-Q. Int Psychogeriatr 4:165–175CrossRefPubMed Crook TH, Feher EP, Larrabee GJ (1992) Assessment of memory complaint in age-associated memory impairment: the MAC-Q. Int Psychogeriatr 4:165–175CrossRefPubMed
21.
go back to reference Koenig HG, Westlund R, George LK et al (1993) Abbreviating the Duke social support index for use in chronically ill elderly individuals. Psychosomatics 34:61–69CrossRefPubMed Koenig HG, Westlund R, George LK et al (1993) Abbreviating the Duke social support index for use in chronically ill elderly individuals. Psychosomatics 34:61–69CrossRefPubMed
22.
go back to reference Goodger B, Byles J, Higginbotham N et al (1999) Assessment of a short scale to measure social support among older people. Aust N Z J Public Health 23:260–265CrossRefPubMed Goodger B, Byles J, Higginbotham N et al (1999) Assessment of a short scale to measure social support among older people. Aust N Z J Public Health 23:260–265CrossRefPubMed
23.
go back to reference Richardson J, Atherton Day N, Peacock S, Iezzi A (2004) Measurement of the quality of life for economic evaluation and the assessment of quality of life (AQoL) Mark 2 Instrument. Aust Econ Rev 37:62–88CrossRef Richardson J, Atherton Day N, Peacock S, Iezzi A (2004) Measurement of the quality of life for economic evaluation and the assessment of quality of life (AQoL) Mark 2 Instrument. Aust Econ Rev 37:62–88CrossRef
26.
go back to reference Davis EA, Jones TW, Walsh P, Byrne GC (1997) The use of biothesiometry to detect neuropathy in children and adolescents with IDDM. Diabetes Care 20:1448–1453CrossRefPubMed Davis EA, Jones TW, Walsh P, Byrne GC (1997) The use of biothesiometry to detect neuropathy in children and adolescents with IDDM. Diabetes Care 20:1448–1453CrossRefPubMed
27.
go back to reference Shy ME, Frohman EM, So YT et al (2003) Quantitative sensory testing: report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology 60:898–904CrossRefPubMed Shy ME, Frohman EM, So YT et al (2003) Quantitative sensory testing: report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology 60:898–904CrossRefPubMed
28.
go back to reference Bartlett G, Stewart JD, Tamblyn R, Abrahamowicz M (1998) Normal distributions of thermal and vibration sensory thresholds. Muscle Nerve 21:367–374CrossRefPubMed Bartlett G, Stewart JD, Tamblyn R, Abrahamowicz M (1998) Normal distributions of thermal and vibration sensory thresholds. Muscle Nerve 21:367–374CrossRefPubMed
29.
go back to reference Inami K, Chiba K, Toyama Y (2005) Determination of reference intervals for vibratory perception thresholds of the lower extremities in normal subjects. J Orthop Sci 10:291–297CrossRefPubMed Inami K, Chiba K, Toyama Y (2005) Determination of reference intervals for vibratory perception thresholds of the lower extremities in normal subjects. J Orthop Sci 10:291–297CrossRefPubMed
30.
go back to reference Hwu CM, Chang HY, Chen JY, Wang SL, Ho LT, Pan WH (2002) Quantitative vibration perception thresholds in normal and diabetic Chinese: influence of age, height and body mass index. Neuroepidemiology 21:271–278CrossRefPubMed Hwu CM, Chang HY, Chen JY, Wang SL, Ho LT, Pan WH (2002) Quantitative vibration perception thresholds in normal and diabetic Chinese: influence of age, height and body mass index. Neuroepidemiology 21:271–278CrossRefPubMed
31.
go back to reference Aaserud O, Juntunen J, Matikainen E (1990) Vibration sensitivity thresholds: methodological considerations. Acta Neurol Scand 82:277–283CrossRefPubMed Aaserud O, Juntunen J, Matikainen E (1990) Vibration sensitivity thresholds: methodological considerations. Acta Neurol Scand 82:277–283CrossRefPubMed
32.
go back to reference Halonen P (1986) Quantitative vibration perception thresholds in healthy subjects of working age. Eur J Appl Physiol Occup Physiol 54:647–655CrossRefPubMed Halonen P (1986) Quantitative vibration perception thresholds in healthy subjects of working age. Eur J Appl Physiol Occup Physiol 54:647–655CrossRefPubMed
33.
go back to reference Peters EW, Bienfait HM, de Visser M, de Haan RJ (2003) The reliability of assessment of vibration sense. Acta Neurol Scand 107:293–298CrossRefPubMed Peters EW, Bienfait HM, de Visser M, de Haan RJ (2003) The reliability of assessment of vibration sense. Acta Neurol Scand 107:293–298CrossRefPubMed
34.
go back to reference Gelber DA, Pfeifer MA, Broadstone VL et al (1995) Components of variance for vibratory and thermal threshold testing in normal and diabetic subjects. J Diabetes Complications 9:170–176CrossRefPubMed Gelber DA, Pfeifer MA, Broadstone VL et al (1995) Components of variance for vibratory and thermal threshold testing in normal and diabetic subjects. J Diabetes Complications 9:170–176CrossRefPubMed
35.
go back to reference de Neeling JN, Beks PJ, Bertelsmann FW, Heine RJ, Bouter LM (1994) Sensory thresholds in older adults: reproducibility and reference values. Muscle Nerve 17:454–461CrossRefPubMed de Neeling JN, Beks PJ, Bertelsmann FW, Heine RJ, Bouter LM (1994) Sensory thresholds in older adults: reproducibility and reference values. Muscle Nerve 17:454–461CrossRefPubMed
36.
go back to reference Lindsell CJ, Griffin MJ (2003) Normative vibrotactile thresholds measured at five European test centres. Int Arch Occup Environ Health 76:517–528CrossRefPubMed Lindsell CJ, Griffin MJ (2003) Normative vibrotactile thresholds measured at five European test centres. Int Arch Occup Environ Health 76:517–528CrossRefPubMed
37.
go back to reference Goldberg JM, Lindblom U (1979) Standardised method of determining vibratory perception thresholds for diagnosis and screening in neurological investigation. J Neurol Neurosurg Psychiatry 42:793–803CrossRefPubMedPubMedCentral Goldberg JM, Lindblom U (1979) Standardised method of determining vibratory perception thresholds for diagnosis and screening in neurological investigation. J Neurol Neurosurg Psychiatry 42:793–803CrossRefPubMedPubMedCentral
38.
go back to reference Vedel JP, Roll JP (1982) Response to pressure and vibration of slowly adapting cutaneous mechanoreceptors in the human foot. Neurosci Lett 34:289–294CrossRefPubMed Vedel JP, Roll JP (1982) Response to pressure and vibration of slowly adapting cutaneous mechanoreceptors in the human foot. Neurosci Lett 34:289–294CrossRefPubMed
39.
go back to reference Wiles PG, Pearce SM, Rice PJ, Mitchell JM (1990) Reduced vibration perception in right hands of normal subjects: an acquired abnormality? Br J Ind Med 47:715–716PubMedPubMedCentral Wiles PG, Pearce SM, Rice PJ, Mitchell JM (1990) Reduced vibration perception in right hands of normal subjects: an acquired abnormality? Br J Ind Med 47:715–716PubMedPubMedCentral
40.
go back to reference Thomson FJ, Masson EA, Boulton AJ (1992) Quantitative vibration perception testing in elderly people: an assessment of variability. Age Ageing 21:171–174CrossRefPubMed Thomson FJ, Masson EA, Boulton AJ (1992) Quantitative vibration perception testing in elderly people: an assessment of variability. Age Ageing 21:171–174CrossRefPubMed
Metadata
Title
Vibrotactile threshold measurement for detecting peripheral neuropathy: defining variability and a normal range for clinical and research use
Authors
J. Duke
M. McEvoy
D. Sibbritt
M. Guest
W. Smith
J. Attia
Publication date
01-11-2007
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 11/2007
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-007-0813-y

Other articles of this Issue 11/2007

Diabetologia 11/2007 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.