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PURPOSE: Neuropathy is a severe progressive loss of protective sensation on the feet, making the patient more vulnerable to mechanical trauma and consequently more suitable to the development of chronic wounds, major distortion of the foot bone architecture and eventually to limb amputation. Recommendations for the prevention of ulceration include evaluation of the degree of loss of sensation on the skin. The PSSD (Pressure Specified Sensory Device) can better quantify the threshold of pressure applied to the skin that could be recognized as positive by the patient. Pressure of one point is tested static, thus assessing function of slow response nerve fibers.
METHODS: One hundred and thirty-six limbs in diabetic patients, type II, with no previous history of wounds on the lower extremity were studied using the tests, one point static (1PE) on the cutaneous territory of the posterior tibial nerve (two territories – medial plantar and calcaneous nerves). The control group (112 non diabetic patients) was assessed by the same exams. The results of diabetic group were compared to evaluation than with conventional Semmes-Weinstein monofilament (MSW) nº 5,07.
RESULTS: Altered values were observed for the static test over the two studied territories. The differences were statistically significant (p < 0,05). Comparing the threshold of sensibility between sensitive and non sensitive diabetic patients to MSW nº 5,07 test, we observed that p-value range was 0,018 < p < 0,113 with 1PE test .
CONCLUSIONS: Our findings suggest that PSSD is an important tool to evaluate the loss of sensation on the foot. For the purpose on insensivity population screening the monofilament 5,07 does not seen to be the best parameter. As the monofilament is a simple tool to be used worldwide, we suggest that MSW 3,22 should replace the 5,07.
METHODS: One hundred and thirty-six limbs in diabetic patients, type II, with no previous history of wounds on the lower extremity were studied using the tests, one point static (1PE) on the cutaneous territory of the posterior tibial nerve (two territories – medial plantar and calcaneous nerves). The control group (112 non diabetic patients) was assessed by the same exams. The results of diabetic group were compared to evaluation than with conventional Semmes-Weinstein monofilament (MSW) nº 5,07.
RESULTS: Altered values were observed for the static test over the two studied territories. The differences were statistically significant (p < 0,05). Comparing the threshold of sensibility between sensitive and non sensitive diabetic patients to MSW nº 5,07 test, we observed that p-value range was 0,018 < p < 0,113 with 1PE test .
CONCLUSIONS: Our findings suggest that PSSD is an important tool to evaluate the loss of sensation on the foot. For the purpose on insensivity population screening the monofilament 5,07 does not seen to be the best parameter. As the monofilament is a simple tool to be used worldwide, we suggest that MSW 3,22 should replace the 5,07.