2005年1月
Effectiveness of Semmes-Weinstein monofilament examination for diabetic peripheral neuropathy screening
JOURNAL OF DIABETES AND ITS COMPLICATIONS
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- 巻
- 19
- 号
- 1
- 開始ページ
- 47
- 終了ページ
- 53
- 記述言語
- 英語
- 掲載種別
- DOI
- 10.1016/j.jdiacomp.2003.12.006
- 出版者・発行元
- ELSEVIER SCIENCE INC
Objective: To evaluate the effectiveness of the Semmes-Weinstein monofilament examination (SWME) for diabetic peripheral neuropathy (DPN) screening at an outpatient clinic. Methods: Eighty-two type 2 diabetic outpatients were questioned about 13 subjective symptoms and tested for deep reflexes. They were examined using two types of quantitative sensory testing: SWME (using 4.31/2 g and 5.07/10 g monofilaments) and vibration testing (using the C-64 quantitative tuning fork). The patients were diagnosed with DPN when two of the following three criteria from both legs were met: (1) the presence of either pain, numbness, or paraesthesia; (2) a diminished or absent ankle reflex; or (3) a scale below 4 for their vibration perception thresholds (VPT). Results: The most common subjective symptoms were muscle cramps and numbness in the extremities. SWME 4.31/2 g at the great toe or the plantar aspect of the fifth metatarsal was the most useful diagnostic test for DPN, providing 60.0% sensitivity and 73.8% specificity. SWME 4.31/2 g was correlated with lower limb VPT (P = .029) and three subjective symptoms including fainting. SWME 5.07/10 g was correlated with lower limb VPT (P = .011), the ankle reflex (P = .013), the knee reflex (P = .031), and two subjective symptoms. However, the sensitivity to diagnose DPN was low (30.0%). Conclusions: The abnormalities indicated by SWME correlated well with those identified by lower limb VPT. Moreover, SWME 4.31/2 g correlated with fainting, suggesting that it could detect abnormalities in the small fibers. Considering the minimal time for this examination, SWME 4.31/2 g is a useful examination in an outpatient setting along with lower limb VPT and ankle reflex testing. (C) 2005 Elsevier Inc. All rights reserved.
- リンク情報
- ID情報
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- DOI : 10.1016/j.jdiacomp.2003.12.006
- ISSN : 1056-8727
- Web of Science ID : WOS:000226961400007