Development of Grading Scales of Pedal Sensory Loss Using Mokken Scale Analysis on the Rotterdam Diabetic Foot Study Test Battery Data

Overview

Journal Muscle Nerve

Date 2019 Jul 9

PMID 31281987

Citations 6

Authors

Willem D Rinkel

M Hosein Aziz

Johan W van Neck

Manuel Castro Cabezas

L Andries van der Ark

J Henk Coert

Affiliations

Soon will be listed here.

Abstract

Introduction: Loss of sensation due to diabetes-related neuropathy often leads to diabetic foot ulceration. Several test instruments are used to assess sensation, such as static and moving 2-point discrimination (S2PD, M2PD), monofilaments, and tuning forks.

Methods: Mokken scale analysis was applied to the Rotterdam Diabetic Foot Study data to select hierarchies of tests to construct measurement scales.

Results: We developed 39-item and 31-item scales to measure loss of sensation for research purposes and a 13-item scale for clinical practice. All instruments were strongly scalable and reliable. The 39 items can be classified into 5 hierarchically ordered core clusters: S2PD, M2PD, vibration sense, monofilaments, and prior ulcer or amputation.

Discussion: Guided by the presented scales, clinicians may better classify the grade of sensory loss in diabetic patients' feet. Thus, a more personalized approach concerning individual recommendations, intervention strategies, and patient information may be applied.

Citing Articles

Development of a prediction model for foot ulcer recurrence in people with diabetes using easy-to-obtain clinical variables.

Aan De Stegge W, Schut M, Abu-Hanna A, van Baal J, van Netten J, Bus S BMJ Open Diabetes Res Care. 2021; 9(1).

PMID: 34301678 PMC: 8311312. DOI: 10.1136/bmjdrc-2021-002257.

A two-step, test-guided Mokken scale analysis, for nonclustered and clustered data.

Koopman L, Zijlstra B, van der Ark L Qual Life Res. 2021; 31(1):25-36.

PMID: 33983619 PMC: 8800881. DOI: 10.1007/s11136-021-02840-2.

Vibrotactile perception on the sole of the foot in an older group of people with normal glucose tolerance and type 2 diabetes.

Peterson M, Pingel R, Rolandsson O, Dahlin L SAGE Open Med. 2020; 8:2050312120931640.

PMID: 32587694 PMC: 7294473. DOI: 10.1177/2050312120931640.

(Cost-)effectiveness of lower extremity nerve decompression surgery in subjects with diabetes: the DeCompression (DECO) trial-study protocol for a randomised controlled trial.

Rinkel W, Fakkel T, Cabezas M, Birnie E, Coert J BMJ Open. 2020; 10(4):e035644.

PMID: 32341044 PMC: 7204866. DOI: 10.1136/bmjopen-2019-035644.

Item reduction of the 39-item Rotterdam Diabetic Foot Study Test Battery using decision tree modelling.

Rinkel W, van der Oest M, Coert J Diabetes Metab Res Rev. 2020; 36(4):e3291.

PMID: 31955486 PMC: 7317595. DOI: 10.1002/dmrr.3291.

References

Mayfield J, Reiber G, Maynard C, Czerniecki J, Sangeorzan B . The epidemiology of lower-extremity disease in veterans with diabetes. Diabetes Care. 2004; 27 Suppl 2:B39-44. DOI: 10.2337/diacare.27.suppl_2.b39. View

Smieja M, Hunt D, Edelman D, Etchells E, Cornuz J, Simel D . Clinical examination for the detection of protective sensation in the feet of diabetic patients. International Cooperative Group for Clinical Examination Research. J Gen Intern Med. 1999; 14(7):418-24. PMC: 1496604. DOI: 10.1046/j.1525-1497.1999.05208.x. View

Hanewinckel R, Drenthen J, Ligthart S, Dehghan A, Franco O, Hofman A . Metabolic syndrome is related to polyneuropathy and impaired peripheral nerve function: a prospective population-based cohort study. J Neurol Neurosurg Psychiatry. 2016; 87(12):1336-1342. DOI: 10.1136/jnnp-2016-314171. View

Hanewinckel R, Ikram M, van Doorn P . Assessment scales for the diagnosis of polyneuropathy. J Peripher Nerv Syst. 2016; 21(2):61-73. DOI: 10.1111/jns.12170. View

Schaper N, Van Netten J, Apelqvist J, Lipsky B, Bakker K . Prevention and management of foot problems in diabetes: a Summary Guidance for Daily Practice 2015, based on the IWGDF Guidance Documents. Diabetes Metab Res Rev. 2015; 32 Suppl 1:7-15. DOI: 10.1002/dmrr.2695. View

Boyko E, Ahroni J, Cohen V, Nelson K, Heagerty P . Prediction of diabetic foot ulcer occurrence using commonly available clinical information: the Seattle Diabetic Foot Study. Diabetes Care. 2006; 29(6):1202-7. DOI: 10.2337/dc05-2031. View

Monteiro-Soares M, Boyko E, Ribeiro J, Ribeiro I, Dinis-Ribeiro M . Predictive factors for diabetic foot ulceration: a systematic review. Diabetes Metab Res Rev. 2012; 28(7):574-600. DOI: 10.1002/dmrr.2319. View

Narayanaswami P, Burns T . Clinical outcome assessments: The "Rasch-Ionale" for improved accuracy. Muscle Nerve. 2018; 58(3):327-329. DOI: 10.1002/mus.26155. View

Patel A, Gaines K, Malamut R, Park T, Del Toro D, Holland N . Usefulness of electrodiagnostic techniques in the evaluation of suspected tarsal tunnel syndrome: an evidence-based review. Muscle Nerve. 2005; 32(2):236-40. DOI: 10.1002/mus.20393. View

10.

Vinik A, Mehrabyan A . Diabetic neuropathies. Med Clin North Am. 2004; 88(4):947-99, xi. DOI: 10.1016/j.mcna.2004.04.009. View

11.

van der Ark L, Croon M, Sijtsma K . Mokken Scale Analysis for Dichotomous Items Using Marginal Models. Psychometrika. 2010; 73(2):183-208. PMC: 2798990. DOI: 10.1007/s11336-007-9034-z. View

12.

Shenkin S, Watson R, Laidlaw K, Starr J, Deary I . The attitudes to ageing questionnaire: Mokken scaling analysis. PLoS One. 2014; 9(6):e99100. PMC: 4043998. DOI: 10.1371/journal.pone.0099100. View

13.

Pare M, Albrecht P, Noto C, Bodkin N, Pittenger G, Schreyer D . Differential hypertrophy and atrophy among all types of cutaneous innervation in the glabrous skin of the monkey hand during aging and naturally occurring type 2 diabetes. J Comp Neurol. 2007; 501(4):543-67. DOI: 10.1002/cne.21262. View

14.

Rinkel W, Rizopoulos D, Aziz M, van Neck J, Cabezas M, Coert J . Grading the loss of sensation in diabetic patients: A psychometric evaluation of the rotterdam diabetic foot study test battery. Muscle Nerve. 2018; 58(4):559-565. PMC: 6646912. DOI: 10.1002/mus.26192. View

15.

Crawford F, Cezard G, Chappell F, Murray G, Price J, Sheikh A . A systematic review and individual patient data meta-analysis of prognostic factors for foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS). Health Technol Assess. 2015; 19(57):1-210. PMC: 4781379. DOI: 10.3310/hta19570. View

16.

Shun C, Chang Y, Wu H, Hsieh S, Lin W, Lin Y . Skin denervation in type 2 diabetes: correlations with diabetic duration and functional impairments. Brain. 2004; 127(Pt 7):1593-605. DOI: 10.1093/brain/awh180. View

17.

Vinik A, Ullal J, Parson H, Casellini C . Diabetic neuropathies: clinical manifestations and current treatment options. Nat Clin Pract Endocrinol Metab. 2006; 2(5):269-81. DOI: 10.1038/ncpendmet0142. View

18.

Monteiro-Soares M, Dinis-Ribeiro M . A new diabetic foot risk assessment tool: DIAFORA. Diabetes Metab Res Rev. 2016; 32(4):429-35. DOI: 10.1002/dmrr.2785. View

19.

van Nes S, Faber C, Hamers R, Harschnitz O, Bakkers M, Hermans M . Revising two-point discrimination assessment in normal aging and in patients with polyneuropathies. J Neurol Neurosurg Psychiatry. 2008; 79(7):832-4. DOI: 10.1136/jnnp.2007.139220. View

20.

Ziegler D, Papanas N, Zhivov A, Allgeier S, Winter K, Ziegler I . Early detection of nerve fiber loss by corneal confocal microscopy and skin biopsy in recently diagnosed type 2 diabetes. Diabetes. 2014; 63(7):2454-63. DOI: 10.2337/db13-1819. View