Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy

摘要

OBJECTIVE—To provide clinically useful vibrationthreshold normal values.
METHODS—The graduated Rydel-Seiffer tuning forkwas evaluated in 198 healthy controls and 59 patients with apolyneuropathy. The measures were done in triplicate at four locations:the distal interphalangeal joint of the index finger, ulnar styloidprocess, interphalangeal joint of the hallux, and internal malleolus.The values obtained with this tuning fork in healthy controls andpatients with polyneuropathy were compared with the values of anelectronic device, the Vibrameter.
RESULTS—Vibration sense was better perceived inthe arms compared with the legs. There was a significant age relateddecline of vibration sense at all locations. The values from theRydel-Seiffer tuning fork and the Vibrameter were significantlycorrelated in both groups. The sensitivity of these two instruments forthe four sites examined in the polyneuropathy group ranged from29-76% and 31-73%, respectively and was the highest at the halluxfor both instruments.
CONCLUSION—This study provides clinical usefulnormal values of vibration threshold for the Rydel-Seiffer tuningfork. This is a simple and easily applicable instrument that assessesvibration sense semiquantitatively and should therefore have a place inroutine neurological examination.