Development of a new device for screening for peripheral diabetic neuropathy

Abstract

Background and aims: We developed a new tool called 'Vibrascan' that utilises a vibratory plate for the screening of peripheral diabetic neuropathy. Its design was based on the mechanics of the Neurothesiometer, but is intended as a more intuitive, operator-independent testing instrument. Materials and methods: Twenty healthy subjects were tested using both Neurothesiometer and VibraScan. For using the Neurothesiometer, a single operator measured VPT (vibration perception thresholds in Volts (V). VibraScan can be operated independently by the subject in the sitting position and placing both feet on the vibrating plate. The range of vibration used is the same for both devices (i.e. from 0V to 50V). The frequency and amplitude of VibraScan is completely programmable such that severity level can be interpreted automatically by the device. VPT measurements by both devices were correlated using the Bland-Altman method in order to measure the agreement between both devices. Results: Mean VPT measured for left and right foot using Neurothesiometer was 4.53 ± 0.65 V and 4.97 ± 0.57 V, and 4.76 ± 0.60 V and 5.22 ± 0.67 V for left and right foot using VibraScan. There was very good correlation between individual values for each device (r = 0.893, p < 0.01 for right foot and r = 0.816, p < 0.01 for left foot). Despite the differences in operation technique, there was very little difference in VPT measurements between devices. when using the using Bland-Altman method. Conclusion: The intuitive, quick and essentially observer independent nature of VibraScan enables an important new normal method of screening for the at risk foot in diabetic individuals. Further studies on diabetic subjects with varying severity of neuropathy are planned to help strengthen its possible role for screening patients in tandem with their annual eye screening visit, a much awaited unified approach in the modern management of diabetes.

Full text

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Development of a new device for screening for peripheral diabetic neuropathy
D. Coppini1,2, J. Dave3, V. Dubey3;
1Poole Hospital, Poole, UK, 2Mater Dei Hospital, Msida, Malta, 3Bournemouth University,
Bournemouth, UK.
Background and aims: We developed a new tool called 'Vibrascan' that utilises a vibratory plate for
the screening of peripheral diabetic neuropathy. Its design was based on the mechanics of the
Neurothesiometer, but is intended as a more intuitive, operator- independent testing instrument.
Materials and methods: Twenty healthy subjects were tested using both Neurothesiometer and
VibraScan. For using the Neurothesiometer, a single operator measured VPT (vibration perception
thresholds in Volts (V). VibraScan can be operated independently by the subject in the sitting position
and placing both feet on the vibrating plate. The range of vibration used is the same for both devices
(i.e. from 0V to 50V). The frequency and amplitude of VibraScan is completely programmable such
that severity level can be interpreted automatically by the device. VPT measurements by both devices
were correlated using the Bland - Altman method in order to measure the agreement between both
devices.
Results: Mean VPT measured for left and right foot using Neurothesiometer was 4.53 ± 0.65 V and
4.97 ± 0.57 V, and 4.76 ± 0.60 V and 5.22 ± 0.67 V for left and right foot using VibraScan. There was
very good correlation between individual values for each device (r = 0.893, p < 0.01 for right foot and
r = 0.816, p < 0.01 for left foot). Despite the differences in operation technique, there was very little
difference in VPT measurements between devices. when using the using Bland-Altman method.
Conclusion: The intuitive, quick and essentially observer independent nature of VibraScan enables an
important new normal method of screening for the at risk foot in diabetic individuals. Further studies
on diabetic subjects with varying severity of neuropathy are planned to help strengthen its possible
role for screening patients in tandem with their annual eye screening visit, a much awaited unified
approach in the modern management of diabetes.
Disclosure: D. Coppini: None.