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

Abstract

Considering 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.