Diagnostic Accuracy of Qualitative Versus Quantitative Tuning Forks

Lai, Saien; Ahmed, Umair; Bollineni, Aruna; Lewis, Richard A.; Ramchandren, Sindhu

doi:10.1097/cnd.0000000000000019

Cited by 20 publications

(13 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the definition of normal CTF vibration threshold was not clearly stated in their article; also, the “ability to perceive vibration” per se would not be adequate to determine the degree of vibration perception to be normal. Recently, Lai et al . reported that they found no statistically significant difference in the sensitivity of the CTF and the RSTF in detecting axonal neuropathy, yet the sensitivity of their results was found to be low with both tuning forks, at 20% and 26%, respectively.…”

Section: Discussionmentioning

confidence: 96%

The conventional tuning fork as a quantitative tool for vibration threshold

et al. 2017

View full text Add to dashboard Cite

Introduction: This study was undertaken to describe a method for quantifying vibration when using a conventional tuning fork (CTF) in comparison to a Rydel-Seiffer tuning fork (RSTF) and to provide reference values. Methods: Vibration thresholds at index finger and big toe were obtained in 281 participants. Spearman's correlations were performed. Age, weight, and height were analyzed for their covariate effects on vibration threshold. Reference values at the fifth percentile were obtained by quantile regression. Results: The correlation coefficients between CTF and RSTF values at finger/ toe were 0.59/0.64 (P 5 0.001 for both). Among covariates, only age had a significant effect on vibration threshold.

show abstract

Section: Discussionmentioning

confidence: 96%

The conventional tuning fork as a quantitative tool for vibration threshold

et al. 2017

View full text Add to dashboard Cite

show abstract

“…This is done by placing the examiner's finger on the opposite surface of the joint being tested from the tuning fork, and noting if the vibration persists after the patient no longer senses it, or assessing the patient's threshold against the examiners, by applying the tuning fork to their finger. [23] The quantitative method involves noting the duration of perceived vibration using a stopwatch. In order to standardize the stimulus, the examiner must strike the 128-Hz tuning fork against the palm of the free hand just hard enough to make the metal ends meet to produce a metallic clanging sound.…”

Section: Discussionmentioning

confidence: 99%

Timed Vibration Sense and Joint Position Sense Testing in the Diagnosis of Distal Sensory Polyneuropathy

Prabhakar

Suresh

Kurian

et al. 2019

Journal of Neurosciences in Rural Practice

View full text Add to dashboard Cite

Introduction: Distal sensory polyneuropathy (DSP) is one of the most common neurological disorders. Although several studies have studied the role of the neurological examination in DSP, there are only limited studies on the utility of timed vibration sense (VBS) and joint position sense (JPS) testing in the diagnosis of DSP. Objectives: The objective is to study the utility of timed VBS testing and JPS testing at the great toe in clinical detection of DSP. Methods: This study was prospectively conducted in the neurology department of a tertiary care hospital in India. Patients with DSP referred to the electrophysiology laboratory from August 2017 to December 2017 were screened. Patients with symptomatic DSP which was confirmed by electrophysiological studies were taken as cases and normal participants with no symptoms or electrophysiological findings suggestive of DSP served as controls. Results: We studied 127 patients and 194 controls. The mean age of the patients was 48.7 (14.5) years in the patient group and 39.7 (14.5) years in the control group. The male: female ratio was 77/50 in the patient group and 112/82 in the control group. Abnormal clinical examination was found in 95% of the patients with DSP. The most common abnormal examination components were impaired ankle reflexes (70%), vibration (85%), and JPS (39.6%) sensation. Using the receiver operating characteristic curve for the diagnosis of DSP, a vibratory response lasting <8 s at the great toe had a sensitivity of 85% and specificity of 42.8%. For JPS testing at the great toe, obtaining two or more incorrect responses had a sensitivity of 33% and specificity of 87.6%. Conclusion: VBS testing was more sensitive and JPS testing was more specific in making a clinical diagnosis of DSP. For timed VBS, duration of >8 s at the great toe was a useful test to rule out DSP, and for JPS testing at the great toe, obtaining two or more incorrect responses was a useful test in ruling in the diagnosis of DSP.

show abstract

“…For screening studies, especially when aiming to describe the frequency of polyneuropathy in the unselected general population, a high sensitivity is important in order not to miss any cases. Studies have shown that this is often not optimal for single test, such as monofilament or tuning fork examination (Perkins et al , ; Wang et al , ; Lai et al , ) . Moreover, distal sensory loss can also be found in healthy people without other signs of polyneuropathy, especially in the elderly (Vrancken et al , ) .…”

Section: Discussionmentioning

confidence: 99%

Assessment scales for the diagnosis of polyneuropathy

Hanewinckel

Ikram

Doorn

2016

J Peripheral Nervous Sys

View full text Add to dashboard Cite

Epidemiological studies that investigate the occurrence and determinants of chronic length-dependent polyneuropathy are scarce. Population-based studies on polyneuropathy require a valid and reliable screening protocol with both good sensitivity and specificity. Several questionnaires and scoring scales have been developed for the detection of polyneuropathy, grading the severity of the disease, or evaluating the clinical course during follow-up. This review summarizes the aims and content of existing diagnostic polyneuropathy screening tools in order to help future studies decide which scale to use for screening in specific situations. We searched the PubMed database and identified 27 scales, 13 are based on symptoms alone, 8 on neurological signs alone, and 6 on a combination of symptoms and signs. Scales that combine questions concerning symptoms and a neurological examination with a focus on sensory alterations seem to have the best discriminatory power. However, all scoring scales were developed for and investigated in prespecified patient populations. Therefore, the generalizability of specific findings to the general population may be limited. We also discuss other limitations of existing scales. Future studies are required to determine which clinimetrically well-developed scales are preferred for use in population-based studies.

show abstract

Diagnostic Accuracy of Qualitative Versus Quantitative Tuning Forks

Cited by 20 publications

References 7 publications

The conventional tuning fork as a quantitative tool for vibration threshold

The conventional tuning fork as a quantitative tool for vibration threshold

Timed Vibration Sense and Joint Position Sense Testing in the Diagnosis of Distal Sensory Polyneuropathy

Assessment scales for the diagnosis of polyneuropathy

Contact Info

Product

Resources

About