![]() The VTP test provides numerical values that can help to follow the course of the risk for foot insensitivity by allowing the care team to grade the education and follow-up of the at-risk group. ![]() ![]() These patients were not detected using the mono-filament test. The mono-filament test identified patient with the highest risk of foot complications, but 37 more patients were identified to be at risk from a VTP > 25 V. Thirty eight patients were identified having abnormal tests and being at risk of foot complications using the mono-filament test 33 of them and 9 more (42 patients (33 + 9)) were identified using the tuning fork applied to the malleolus and eight more (50 patients (33 + 9 + 8)) when the tuning fork was applied to the big toe twenty more patients (70 (33 + 9 + 8 + 20)) were identified as being at risk using the VTP at a cut-off of 25 V. In the Weber test, a vibrating tuning fork (preferably 128 Hz) is placed in the middle of the forehead, and normally the patient will localize the vibration. The 10 g mono-filament, tuning fork and Horwell neuro-esthesiometer were applied to different sites on the patients' legs and feet. Two hundred and fifty consecutive patients followed-up in a diabetic clinic were screened for sensitive polyneuropathy by three different tests in three different examinations in a blind design. Results: The results of all the tuning forks (256, 512, 1024 Hz) shows that 29 patients were Rinne’s positive to all tuning forks had the air-bone gap range of 15 dB to 19 dB with a mean air-bone gap of 17.63 dB. To compare normal and pathologic values of three different tests for screening patients at risk of foot complications: mono-filament, tuning fork and vibration threshold perception (VTP). examination including Rinne test with three different tuning forks (256, 512, 1024 Hz).
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