Sensory testing

[Erika Salazar Alaniz]

Hi Chrissy! In the “Evaluation of Peripheral Neuropathy” section in the module named “Motor Neuron Disease” slide 7.29 names sensory testing as light touch, proprio, vibration, pain, temp, AND PROTECTIVE SENSATION. Many resources in an entry level DPT program define protective sensation as: pain, temp, and pressure (monofilament testing) are you suggesting monofilament testing (for NCS purposes) equates to only monofilament testing? There is also evidence that although perhaps not as functional as the others, some view vibration just as reliable as monofilaments for protective sensation (I can’t think of the source right now) even though it really is most useful to assess sensation on healing injuries. TiA!

[Chrissy Durrough Lugge]

Hi Erika! Thanks for this question! When I made this slide, I was thinking of monofilament testing when I mentioned protective sensation. I did a quick search of the literature today and found that most sources are using monofilament testing as the primary means of screening protective sensation (although, as mentioned in the lecture, screening other modalities is also important).

I found a couple articles indicating that vibration may be a beneficial addition to the protective sensation screen: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966840/pdf/13047_2020_Article_371.pdf and https://onlinelibrary.wiley.com/doi/pdf/10.1111/dme.13989.

For NCS purposes, I think understanding the components of a comprehensive sensation screen, including using a Semmes-Weinstein 5.07 monofilament, is sufficient.

Hope this helps!

Chrissy

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