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Table 2 Baseline data: neurological assessment

From: Risk factors for foot ulceration in adults with end-stage renal disease on dialysis: study protocol for a prospective observational cohort study

Neurological assessments Equipment Procedure Diagnosis/study definition
Known peripheral neuropathy N/A Medical record review. History of peripheral neuropathy documented in medical records.
Loss of protective sensation Baily Instruments Ltd® (Salford Quays, UK) Semmes-Weinstein 5.07/10 g monofilament [37]. • Monofilament is first applied to participant’s hand or elbow (so that the participant knows what sensation to expect) Failure to detect the monofilament at a specific site, even after re-testing the deficit site, in at least one foot will result in a failed test (i.e. score of <3/3 on either foot) [36].
• Ensure the participant’s eyes are closed
• Monofilament applied perpendicular to the skin and held for 1–2 secs, applying sufficient force to bend or buckle the monofilament fibre [16]
• Monofilament applied to the plantar aspects of the hallux, first metatarsophalangeal joint and fifth metatarsophalangeal joint of both feet [36, 43]
• Participant is asked by the assessor to respond “yes” when they feel the monofilament
• This is repeated for all 3 sites on each foot (6 sites in total)
• Deficit sites will be re-tested once
• A monofilament will be not be used on more than 10 participants, without a recovery period of 24 hrs [16, 37, 91]
Vibration perception threshold Horwell® Neurothesiometer (Wilford, Nottingham, UK). • Neurothesiometer is first applied to the participant’s hand or elbow (so that the participant knows what sensation to expect) Vibration perception threshold >25 V in at least one foot will result in a failed test [4043].
• Participant is asked to close their eyes and to report “yes” when they first start to feel a vibratory sensation
• Neurothesiometer is applied to the apex of the hallux and the voltage is gradually increased until the participant perceives the vibratory sensation [40, 43]
• The minimum reading at which the vibratory sensation is perceived will be recorded (this is repeated 3 times and an average score is recorded for both feet) [40, 43]
Note: Vibration perception threshold will be measured at the base of the first, third or fifth metatarsals if there are current ulcers on the hallux, or previous amputation of the hallux [43].
  1. N/A Not applicable