Semmes-Weinstein 5.07/10 g Monofilament |
128 Hz Tuning Fork |
Detects loss of protective sensation |
Assesses integrity of only large fibers |
Applied perpendicular to skin surface with enough force to cause filament to bend or buckle |
Applied to bony prominence, bilaterally, at the dorsum of the first toe, proximal to the nail bed |
Monofilament applied first to hands, elbow, or forehead |
Tuning fork placed on foot for 10 seconds; if patient requires greater than 10 seconds to detect, vibration sensitivity is compromised |
Patient must not see when clinician places filament |
Good predictor of long-term complications characteristic of DPN |
Apply monofilament to multiple sites on each foot
Do not apply filament to perimeter, nor on an ulcer, callus, scar, or necrotic tissue
Patient responds “yes” when monofilament is felt
A negative response at any site identifies loss of proactive sensation, indicating a foot at high risk for ulceration |
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