Evaluating Lower Extremity Sensation


Sensation (also referred to as "protective threshold") can be clinically evaluated in patients with diabetes mellitus by using one of several different techniques. The most commonly used method involves the use of a Semmes-Weinstein 5.07 log (10g) monofilament. The device is placed in contact with the plantar aspect of the patient's foot and pressure is applied until the monofilament begins to buckle. Sensation is intact if the patient can feel the monofilament when it buckles against the skin. Another technique involves the concept of vibration perception. If the patient has a vibration perception threshold < 25 volts, sensation is said to be intact.

(References: Plantar sensory threshold in the ulcerative foot. Lepr Rev 57:261, 1986 and The prediction of diabetic neuropathic foot ulceration using vibration perception thresholds. Diabetes Care 16:557, 1994.)

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