Vibration perception threshold testing in patients with diabetic neuropathy: ceiling effects and reliability

• Published in: Diabetic medicine Vol. 18; no. 6; pp. 469 - 475
• Main Authors: Van Deursen, R. W. M., Sanchez, M. M., Derr, J. A., Becker, M. B., Ulbrecht, J. S., Cavanagh, P. R.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.06.2001; Blackwell
• Subjects: Associated diseases and complications; Biological and medical sciences; Diabetes. Impaired glucose tolerance; Diabetic Neuropathies - diagnosis; Diabetic Neuropathies - physiopathology; diabetic polyneuropathy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Male; Medical sciences; Middle Aged; Neurologic Examination - instrumentation; Neurologic Examination - methods; Reference Values; reliability; Reproducibility of Results; Sensory Thresholds - physiology; Vibration; vibration perception threshold; Endocrinopathy; Human; Nervous system diseases; Vibration; Diabetes mellitus; Perception threshold; Complication; Peripheral nerve disease; Measurement method; Peripheral neuropathy; Vibrometer
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1046/j.1464-5491.2001.00503.x

Aims  To test the reliability of a new vibrometer (Maxivibrometer) which was constructed so that vibration perception threshold (VPT) could be determined without the disadvantage of the off‐scale measurements frequently experienced with the Biothesiometer. Methods  The two devices were compared and tested on a group of diabetic neuropathic subjects and a group of healthy, matched control subjects. VPT was tested on the plantar surface of the feet. Results  The Maxivibrometer gave an actual measurement in all cases even if subjects were severely neuropathic. The replication‐to‐replication and day‐to‐day intraclass correlation coefficients for the Maxivibrometer VPT were, except in one case, above 0.94, indicating excellent reliability. The Biothesiometer VPT could also be measured with excellent reliability but only within a limited range of mild to moderate neuropathy, so it appears to be an appropriate screening tool. The replication‐to‐replication intraclass correlation coefficient was 0.93. Conclusions  Because VPT could be measured over a wide range with the Maxivibrometer, it was demonstrated that loss of sensation in diabetic neuropathy can progress far beyond the maximum VPT value of the Biothesiometer. The wide measurement range and the excellent reliability make the Maxivibrometer a valuable research tool to quantify loss of sensation, particularly in the presence of severe neuropathy and to record changes over time. Diabet. Med. 18, 469–475 (2001)