The MNSI questionnaire is self-administered. Responses are added to obtain a total score. ’Yes‘ responses to questions 1–3, 5–6, 8–9, 11–12, 14–15 are each counted as one point. ’No‘ responses to questions 7 and 13 each count as one point. Question 4 was considered to be a measure of impaired circulation and question 10 a measure of general asthenia and were not included in the published scoring algorithm [1 (link)]. A score of ≥ 7 was considered abnormal [1 (link)]. All 15 questions were included in the new scoring algorithms.
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)].
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)].
