糖尿病患者足部周邊神經病變之測試－技術報告

Foot Sensibility Test in Diabetic Patients-A Technical Report

高宓憶(Mi-Yi Kao) ； 許青翎(Ching-Ling Hsu) ； 吳英黛(Ying-Tai Wu)

《物理治療》 32卷1期 (2007/02) Pp. 25-32

摘要

糖尿病周邊神經病變為糖尿病患者常見之併發症且是造成足部潰瘍之主因，進而影響患者之日常生活品質及增加死亡率。糖尿病患者在接受物理治療運動訓練時，周邊感覺異常或足部保護性感覺的篩檢也是重要的注意事項之一。本文旨在介紹一些簡單的測試工具，如SW單股線、振動感覺閾測試、電流感覺閾測試，討論其信、效度和影響因素，以及應用於足部之測試步驟。5.07S-W單股線在臨床普遍被用於測試足部保護性感覺、最具區辨力；128-Hz標準音叉則是可量化振動感覺之合適工具；電流感覺閾測試器乃是利用不同頻率之電流來評估不同大小之神經纖維的感覺功能。三種測試方法需時不多、容易執行、均為非侵入性，也都有中等以上的再測信度，常用於篩檢糖尿病周邊神經病變，以便早期偵測出糖尿病患者神經功能異常之狀況，降低併發症如足部潰瘍之產生。

關鍵字

糖尿病足 ； 周邊神經病變

並列摘要

Diabetic neuropathy is a common complication of diabetes and related to foot ulcer, patients' quality of life and the prognosis. The onset is insidious and the course is chronic and progressive. The foot sensibility screening test is especially important for physical therapists to prevent injuries during exercise training. Three simple, noninvasive, and commonly used clinical screening methods, including testing of Semmes-Weinstein monofilament, vibration perception threshold, and current perception threshold, were introduced. They are used to test the foot protective sensation, vibration sensation, and sensation conducted from large to small nerve fibers, respectively. This technical report also presented the reproducibility, validity, application procedure, and the interpretation of these three testing methods. These tests all have modest reproducibility and are important for early detection of abnormal sensation in patients' feet and prevention of complications from diabetes, such as foot ulcer.

並列關鍵字

Diabetic foot ； Neuropathy