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Rehab Measures: Bioesthesiometer

Link to instrument

 

Title of Assessment

Bioesthesiometer 

Acronym

 

Instrument Reviewer(s)

Initially reviewed by Gail L. Widener and the MS task force of the neurology section of the APTA in 2011.

Summary Date

8/19/2013 

Purpose

The bioesthesiometer is an instrument designed to measure vibration perception threshold (VPT). Initially designed to measure vibration to aid in diagnosis of peripheral neuropathy in persons with diabetes mellitus.

Description

Tool is only available commercially from many sources. The probe is applied to the body while gradually increasing the amplitude until the vibration is detected. Conversely, the amplitude can be slowly lowered to record the amplitude at which vibration sense is lost. Threshold is the value at which VPT is first perceived. As with sensory tests, communication dysfunction may make this test less reliable. Instrument psychometric properties have not been tested in people with MS. For research purposes, this tool is not recommended because of lack of psychometric data in MS.

Area of Assessment

 

Body Part

 

ICF Domain

Body Structure; Body Function 

Domain

 

Assessment Type

Patient Reported Outcomes 

Length of Test

06 to 30 Minutes 

Time to Administer

5 - 10 minutes

Number of Items

Equipment Required

Bioesthesiometer

Training Required

None

Type of training required

no training 

Cost

Not Free 

Actual Cost

Sold commercially from many sources

Age Range

Child: 6-12 years; Adolescent: 13-17 years 

Administration Mode

 

Diagnosis

Multiple Sclerosis 

Populations Tested

Multiple sclerosis

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Multiple Sclerosis:

(Bloom et al, 1984; n = 519 non-diabetic individuals ages from 10-90)

Test-retest Reliability

Multiple Sclerosis:

(Miranda-Palmer et al, 2005; n = 80 people with MS)

  • Excellent test-retest reliability for hands and feet ( r = 0.87)

Interrater/Intrarater Reliability

Not Established

Internal Consistency

Not Established

Criterion Validity (Predictive/Concurrent)

Multiple Sclerosis:

(Leocani et al, 2003)

  • Adequate correlation with sensory evoked potentials in upper limb (rho = 0.372)
  • Adequate correlation with sensory evoked potentials in lower limb (rho = 0.499)

Construct Validity (Convergent/Discriminant)

Not Established

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

Not Established

Responsiveness

Multiple Sclerosis:

(Miranda-Palma et al, 2005)

  • 92% sensitivity and 39% specificity for detecting foot ulceration in patients with DM

Professional Association Recommendations

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

MS EDGE

UR

UR

UR

UR

UR

 

Recommendations based on EDSS Classification:

 

EDSS 0.0 – 3.5

EDSS 4.0 – 5.5

EDSS 6.0 – 7.5

EDSS 8.0 – 9.5

MS EDGE

UR

UR

UR

UR

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

MS EDGE

No

No

No

Yes

Considerations

Bibliography

Bloom, S., Till, S., et al. (1984). "Use of a biothesiometer to measure individual vibration thresholds and their variation in 519 non-diabetic subjects." British medical journal (Clinical research ed.) 288(6433): 1793-1795.

Bove, F. J., Letz, R., et al. (1989). "Sensory thresholds among construction trade painters: a cross-sectional study using new methods for measuring temperature and vibration sensitivity." J. OCCUP. MED. 31(4): 320-325.

Citaker, S., Gunduz, A. G., et al. (2011). "Relationship between foot sensation and standing balance in patients with multiple sclerosis." Gait & Posture.

Frenette, B., Mergler, D., et al. (1990). "Measurement precision of a portable instrument to assess vibrotactile perception threshold." Eur J Appl Physiol Occup Physiol 61(5-6): 386-391. Find it on PubMed

Kakigi, R., Kuroda, Y., et al. (1992). "Physiological study of the spinothalamic tract conduction in multiple sclerosis." J Neurol Sci 107(2): 205-209. Find it on PubMed

Leocani, L., Martinelli, V., et al. (2003). "Somatosensory evoked potentials and sensory involvement in multiple sclerosis: comparison with clinical findings and quantitative sensory tests." Mult Scler 9(3): 275-279. Find it on PubMed

Miranda-Palma, B., Sosenko, J. M., et al. (2005). "A comparison of the monofilament with other testing modalities for foot ulcer susceptibility." Diabetes Res Clin Pract 70(1): 8-12. Find it on PubMed

Newsome, S. D., Wang, J. I., et al. (2011). "Quantitative measures detect sensory and motor impairments in multiple sclerosis." J Neurol Sci 305(1-2): 103-111. Find it on PubMed

van Deursen, R. W., Sanchez, M. M., et al. (2001). "Vibration perception threshold testing in patients with diabetic neuropathy: ceiling effects and reliability." Diabet Med 18(6): 469-475. Find it on PubMed

Zackowski, K. M., Smith, S. A., et al. (2009). "Sensorimotor dysfunction in multiple sclerosis and column-specific magnetization transfer-imaging abnormalities in the spinal cord." Brain 132(Pt 5): 1200-1209. Find it on PubMed

Year published

1984 

Instrument in PDF Format

No 
Approval Status Approved 
 
Attachments
Created at 2/21/2014 1:18 PM  by Jason Raad 
Last modified at 11/20/2014 2:43 PM  by Jason Raad