Theoretical and Natural Science
- The Open Access Proceedings Series for Conferences
Theoretical and Natural Science
Vol. 20, 20 December 2023
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A hand-held electro-mechanical exciter for multi-frequency peripheral neuropathy assessment
* Author to whom correspondence should be addressed.
Abstract
Diabetes is becoming alarmingly common worldwide and is associated with long-term complications. One of the major and common complications of the disease is peripheral neuropathy, which causes loss of sensation in the patient's limbs due to the degeneration of sensory nerves. Loss of sensation often allows injuries to get unnoticed, which increases the risk of infections that may lead to ulcers and amputation. Several tests are used as part of peripheral neuropathy screening, one of which is the vibration perception threshold (VPT) test. Most of the existing instruments for VPT testing apply a stimulus at a single frequency while gradually increasing the vibration acceleration until the stimulus is felt and reported by the subject. Nevertheless, recent studies have shown that performing VPT at several frequencies offers a comprehensive VPT assessment. Moreover, the literature indicates that VPT evaluation is affected by excessive pressure that may be applied by the operator while the vibrator’s head is in contact with the skin. In this work, we describe the design of a hand-held exciter instrument capable of applying multifrequency stimuli in the range 4 Hz – 500 Hz and that prevents excessive pressure from being applied by the operator to the subject’s skin.
Keywords
Diabetes, Peripheral Neuropathy, Quantitative Sensory Testing, Vibration Perception Threshold, Multi-Frequency Assessment
References
1. Seeley, R., Stephens, T., and Tate, P., [Anatomy and Physiology], William C. Brown, St. Louis, 591-592 (1995).
2. International Diabetes Federation, “United Arab Emirates Diabetes report 2000 – 2045,” 2023, https://diabetesatlas.org/data/en/country/208/ae.html, (10/01/2023).
3. Lavery, L., Armstrong, D., and Boulton, A., "Screening for Diabetic Peripheral Neuropathy,". Diabetic Microvascular Complications Today, October, 17-19 (2004).
4. Cornblath, D., "Diabetic Neuropathy: Diagnostic Methods," Advanced Studies in Medicine 4, S650-S661 (2004).
5. Asbury, A. K., Porte, D., Genuth, S. M., Griffin, J., Halter, J. B., Kimura, J., Kuller, L. H., McLeod, J. G., Ochoa, J. L., and Ward, J. D., "Report and recommendations of the San Antonio conference on diabetic Neuropathy (Consensus Statement)," Diabetes Care 11, 592-597 (1988).
6. Chong, P., and Cros, D., "Technology Literature Review: Quantitative Sensory Testing," Muscle Nerve 29, 734-747 (2004).
7. Williamson, R., "The Vibrating Sensation in Diseases of the Nervous System," American Journal of the Medical Sciences 164, 715-726 (1922).
8. Martina, I., v. Koningsveld, R., Schmitz, P., v. d. Meché, P., and v. Doorn, P., "Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy," Journal of Neurology, Neurosurgery, and Psychiatry 65, 743–747 (1998).
9. Garrow, A., and Boulton, A., "Vibration perception threshold – a valuable assessment of neural dysfunction in people with diabetes," Diabetes/Metabolism Research and Reviews 22, 411–419 (2006).
10. Wenemark, M., Lundstrom, R., Hagberg, M., and Nilsson, T., "Vibrotactile perception thresholds as determined by two different devices in a working population," Scandinavian Journal of Work, Environment & Health 22, 204-210 (1996).
11. Gerr, F., and Letz, R., "Reliability of a widely used test of peripheral cutaneous vibration sensitivity and a comparison of two testing protocols," British Journal of Industrial Medicine 45, 635-639 (1988).
12. Meier, P., Berde, C., DiCanzio, J., Zurakowski, D., and Sethna, N., "Quantitative assessment of cutaneous thermal and vibration sensation and thermal pain detection thresholds in healthy children and adolescents," Muscle Nerve 24, 1339-1345 (2001).
13. DeJong (editor), [The Neurologic Examination], Lippincott Williams & Wilkins, Philadelphia, 526 (2013).
14. Nelander, J., Speidel, T., Bjorkman, A., and Dahlin, L. B., “Vibration thresholds are increased at low frequencies in the sole of the foot in diabetes—a novel multi-frequency approach,” Diabet. Med. 29, e449–e456 (2012).
15. Lindholm, E., Londahl, M., Fagher, K., Apelqvist, J., and Dahlin, L. B., “Strong association between vibration perception thresholds at low frequencies (4 and 8 Hz), neuropathic symptoms and diabetic foot ulcers,” PLoS ONE 14(2), e0212921 (2019).
16. Thomson, F. J., Masson, E. A., and Boulton, A., “Quantitative vibration perception testing in elderly people: an assessment of variability,” Age and Ageing 21, 171–174 (1992).
17. Cassella, J. P., Ashford, R. L., and Kavanagh-Sharp, V., “Effect of applied pressure in the determination of vibration sensitivity using the Neurothesiometer,” The Foot10, 27-30 (2000).
Data Availability
The datasets used and/or analyzed during the current study will be available from the authors upon reasonable request.
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- Volume Title
- Proceedings of the 3rd International Conference on Biological Engineering and Medical Science
- ISBN (Print)
- 978-1-83558-213-8
- ISBN (Online)
- 978-1-83558-214-5
- Published Date
- 20 December 2023
- Series
- Theoretical and Natural Science
- ISSN (Print)
- 2753-8818
- ISSN (Online)
- 2753-8826
- DOI
- 10.54254/2753-8818/20/20230725
- Copyright
- 20 December 2023
- Open Access
- This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited