Articles

Vibration Sense

Examination Technique:

  • use a 128 hertz vibration fork
  • apply the stimulus over the distal phalanx of the index finger or large toe.
  • ask the patient to report whether they feel vibration sense and then to report when it stops in order to assess the minimal threshold to perceive the stimulus.
  • compare to your own extremities.

512Hz Tuning Fork

Position Sense

Examination Technique:

  • demonstrate to the patient initially with eyes open that you will be moving their digit up (towards their head) or down (towards their feet).
  • ask the patient to close their eyes.
  • stabilize the distal interphalangeal joint of the upper extremity and make minimal movements upwards or downwards and ask the patient to report after each movement the direction of movement.
  • similarly in the lower extremities, stabilize the interphalangeal joint and move the large toe up or down.