During the MNSI examination, a health professional inspects each foot for deformities, dry skin, calluses, infections and fissures. Each foot with any abnormality receives a score of 1. Each foot is also inspected for ulcers and each foot with an ulcer receives a score of 1. The ankle reflexes are also elicited. If the reflex is absent, the patient is asked to perform the Jendrassic manoeuver and, if present, the reflex is designated as present with reinforcement and is scored as 0.5. If the reflex is absent with the Jendrassic manoeuver, the reflex is designated as absent and is scored as 1. Vibration sensation is then tested in the great toe using a 128-Hz tuning fork. In general, the examiner should be able to feel vibration in his or her hand for 5 s longer than a normal subject can at the great toe. Vibration is scored as present if the examiner senses the vibration on his or her finger for < 10 s longer than the subject feels it in the great toe, decreased if sensed for ≥ 10 s (scored as 0.5) or absent (scored as 1). The total possible score is 8 points and, in the published scoring algorithm, a score ≥ 2.5 is considered abnormal [1 (link)].
Diabetic Neuropathy Assessment Protocol
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Corresponding Organization :
Other organizations : University of Michigan–Ann Arbor, George Washington University
Protocol cited in 46 other protocols
Variable analysis
- None explicitly mentioned
- Total score on the MNSI questionnaire
- Presence of foot deformities, dry skin, calluses, infections, and fissures
- Presence of foot ulcers
- Presence and quality of ankle reflexes
- Vibration sensation in the great toe
- None explicitly mentioned
- Positive control: None mentioned
- Negative control: None mentioned
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