The Rydel Seiffer tuning fork: an inexpensive device for screening diabetic patients with high‐risk foot

Abstract

AbstractConsidering the simple and inexpensive nature of the graduated tuning fork, we evaluated its usefulness in screening for vibratory sensation loss in non‐diabetic and diabetic subjects, compared with the values obtained with biothesiometer. The vibration perception scores were tested in 195 non‐diabetic healthy control subjects (n=195, M:F, 80:115, Mean±SD, age 50.3±10.4 (years), in 455 Type 2 diabetic subjects who had signs and symptoms of sensory neuropathy and abnormal biothesiometric readings (reading>25V), (n=455, M:F 326:129, Mean Age 58.1±7.7 years, HbA1c 10.1±2.4%) and in 471 diabetic patients with no evidence of neuropathy by biothesiometry. (M:F 299:172, Mean Age 48.0±7.5 years, HbA1c 9.5±2.2%). Patients with neuropathy had a lower mean score of 4.5±2.6 compared with the non‐neuropathy cases (7.7±0.5, P<0.001). Among the 455 patients identified as having neuropathy by abnormal biothesiometric values, 235 had an abnormal tuning fork score of ≤4.0. Tuning fork scores were normal in all the 471 non‐neuropathy cases, thus giving a specificity of 100%. This study shows that the graduated tuning fork has a high specificity and a fairly good sensitivity in the diagnosis of diabetic foot problems. Copyright © 2001 John Wiley & Sons, Ltd.