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Tag Archive: vibration testing

1. ADA releases Standards of Care in Diabetes—2023

   December 17, 2022 3:36 pm Leave a Comment

   The American Diabetes Association just released their 2023 version of it’s Standards of Care in Diabetes. The Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes chapter again reflects the latest evidenced-based guidelines on the treatment of the diabetic foot. Some newer recommendations include topical oxygen therapy for recalcitrant diabetic foot ulcers and alpha lipoic acid for neuropathic pain. Testing patients with diabetes for Loss of Protective Sensation (LOPS) with a 10g monofilament and at least one other neurological screening tool is again advised. One of these approved methods includes vibration testing with the 128 Hz tuning fork or “similar device”. These guidelines are in agreement with our latest ETF research paper, Combined Utility of the Semmes-Weinstein Monofilament and the Timed Vibration Test in the Prediction of Diabetic Foot Ulcers.

   

2. New Study Finds Vibration Testing More Reliable than Monofilament over Plantar Calluses

   October 23, 2022 11:10 am Leave a Comment

   Wynands et al’s recently published “Does plantar skin abrasion affect cutaneous mechanosensation?” brings into focus the importance of plantar callus debridement.  This study measured skin thickness, hardness, monofilament threshold and vibration perception threshold (VPT) in healthy participants over plantar calluses before and after “abrasion” (debridement). The intervention group was compared to a matched control group without callus debridement. Findings included significantly reduced skin thickness and hardness as to be expected after callus debridement. Interestingly, VPTs at 30Hz and 200Hz were not significantly affected by debridement. Monofilament thresholds however were significantly improved after the intervention. This finding led the authors to conclude:

   “Since VPTs are not affected by skin properties, they are likely to be the best choice to analyze sensory deterioration in diabetic feet, where skin property changes could skew data of devices like monofilaments.”

   This recommendation aligns with American Diabetes Association Guidelines for using vibration(large-fiber function) and pinprick/temperature (small-fiber function) testing along with the 10g monofilament when testing for loss of protective sensation (LOPS) in patients with diabetes. Another conclusion drawn from this study is that callus debridement improves light touch perception in healthy study participants. Future studies might evaluate this intervention in patients with varying degrees of diabetic peripheral neuropathy (DPN). Perhaps in addition to reducing pressures on the skin, debridement also will be found to improve skin sensitivity in this at risk group. 

   

3. ETF128 selected for vibration testing in Benfotiamine clinical trials

   July 21, 2022 6:18 pm Leave a Comment

   The company was please to learn that the ETF128 will be one of the vibration testing methods utilized in an international clinical trial assessing the effects of benfotiamine on patients with diabetic peripheral neuropathy (DPN). This randomized, double-blind, placebo-controlled study will compare  benfotiamine 300 mg twice per day to placebo over 12 months. Vibration testing with the ETF will be one of several nerve function tests measuring secondary endpoints. We are looking forward to the outcomes of this well-designed study as benfotiamine is one of the most promising supplements on the horizon for patients with DPN.

4. New Study Recommends ETF as Best Choice in Vibration Testing for Diabetic Patients

   May 23, 2019 10:53 am Leave a Comment

   We are excited to report the results of recently published research article utilizing the ETF. This study by Raymond et al. from the Journal of Diabetes Science and Technology has recommended the ETF as the best choice of vibration testing instruments to pair with Semmes-Weinstein monofilament testing when performing lower extremity sensation testing in diabetic patients.  This study protocol compared the ETF to the traditional 128 Hz tuning fork and biothesiometer in terms of ease of use, testing time and standardization of vibration output. The authors recommended the ETF over the other devices. We welcome the results of this study and look forward to more research papers validating the clinical use of the ETF.

    

5. Vibration Testing Improves Post-Op Pain Relief

   December 8, 2017 5:04 pm Leave a Comment

   In our research into emerging uses for tuning forks, we came across an interesting study by Kothari et al. In their article, they hypothesized that improved timing of post-operative analgesics could be achieved by assessing the return of vibration perception. Specifically, they studied 60 male patients who had undergone inguinal herniorrhaphy under subarachnoid block. Patients were evenly divided into control and experimental groups. The experimental group was given medication upon return of vibration sense, controls were given their doses after complaining of pain. All patients had vibration testing performed at the anterior superior iliac spine (ASIS) reasoning that this large nerve fiber function would precede the recovery of small nerve fibers responsible for pain sensation. They suggested that optimal timing of analgesic administration could be achieved by monitoring the return of vibration perception thereby reducing patient pain and the need for additional pain medication.

   The results of this study were promising as Kothari noted in their discussion: “…we conclude that if analgesic is given with the return of vibration sense as compared to actual return of subjective pain at the surgical site, then not only patient compliance is better (low VAS Score) but the respiratory and haemodynamic parameters also remain stable.”

   Although this technique has not yet gained widespread popularity, it could develop into a helpful method of improving pain relief following surgery in the future.