Timely Neuropathy Testing
TNT1st™
SEMMES-WEINSTEIN
COLOR
MONOFILAMENTS™
ORIGINAL HANDLE STYLE
TNT1st™
WITHIN NORMAL LIMITS SET
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50
milligram level*
and/or
200 milligram level**
*2.83 [green] within normal limits 50 milligram
level HAND
The 50 milligram level monofilament has been a standard for identifying
"within normal limits" sensation in the hand and body for men and women.
**3.61 [blue] diminished light touch 200
milligram level HAND
/Normal plantar FOOT
Some contact areas of the plantar surface of the foot where
there is often a little callus may not detect this monofilament in normal
subjects, thus for the plantar surface of the foot the 200 mg level is still
considered within normal limits in shoe wearing populations. Sites under and
inside the toes, and the instep of the foot usually do respond to the 2.83 in
normal subjects. Heavier monofilament threshold levels will map out areas of
abnormality for mapping areas of nerve change as happens anywhere on the body.
Sensibility on the dorsum of the foot is not significantly different from the
dorsum of the hand, thus the 2.82 is still a good monitor for normal threshold
on the dorsum of the foot. In non shoe wearing populations with increased
callus, early nerve changes may be masked somewhat by degrees of callus, and
this should be kept in consideration. Areas of change specific to nerve areas
can sill be determined and mapped if desired with higher threshold
monofilaments. (See Hand Screen and
Foot Screen).
Bell JA: "Sensibility Testing" , In Hunter JM,
Schneider LH, Mackin EJ, and Bell JA (eds),
Rehabilitation of the Hand,
Philadelphia, CV Mosby:269-291, 1978.
Bell-Krotoski JA, Fess EE, Hiltz D, Figarola J: Threshold Detection and
Semmes Weinstein Monofilaments: A Comparative Study, J Hand Ther,
8:155-162, 1995.
Jeng C, Michelson J, Mizel, Sensory
thresholds of normal human feet, Foot Ankle Int., Jun;21(6):501-4, 2000.
Semmes J, Weinstein S, Ghent l, Teuber
HL: Somatosensory Changes After Penetrating Brain Wounds in Man, Cambridge,
Mass, Harvard University Press, 1960.
von Prince K, Butler B: Measuring Sensory Function of the Hand in Peripheral
Nerve Injuries, American J Occup Ther, 21:385-396,
1967.
Weinstein S: Intensive and Extensive Aspects of Tactile Sensitivity as a
Function of Body Part, Sex, and Laterality, in Kenshalo’s The
Skin Senses.
Weinstein S: "Tactile Sensitivity of the Phalanges" in
Perceptual and Motor Skills,
Southern University Press, 14:351-354,
1962.
Werner J, Omer GE: Evaluating Cutaneous Pressure Sensation of the Hand, Am
J Occup Ther, 24:347-356, 1970.
