Comprehensive review on diabetic foot ulcers and neuropathy: Treatment, prevention and management

Table 2 Essential elements for sensorimotor polyneuropathy diagnosis in neurological basic assessment

Predictors	Test	Outcome
Pain perception	Pinprick testing such as 10-g monofilament and Semmes-Weinstein monofilament at the distal plantar sections of the big toe, the plantar side of metatarsals 1 or 2	Decreased distal symmetry sensation at least at one location
Temperature	Infrared thermometer (contact or noncontact) to generate thermal image	Raised temperature especially around DFUs
Vibration	Tuning fork test near the toes and fingers	VPT testing. Reference range vary between 5/8 or 6/8 according to age
Proprioception	Position perception when toes are moved passively by examiner e.g., at distal interphalangeal joints	Errors in detecting small amplitude movements
Autonomic muscle reactions	Achilles tendon reflex, patellar reflex	Decreased or lost in symmetrical way

VPT: Vibration perception threshold; DFU: Diabetic foot ulcer.