Lightly touching the toes of a patient with diabetes is an effective way to assess the risk of foot ulcers, research shows.
A UK study noted that in the absence of neurologic devices such as monofilament, many doctors “touch the feet with cotton wool or even their fingers”. The team from Ipswich Hospital in Norfolk formalised the method into a technique they called the ‘Ipswich Touch Test’.
The test involves lightly touching or resting the tip of the index finger for one-to-two seconds on the tips of the first, third and fifth toes and (optionally) the dorsum of the hallux of both feet. Neuropathy is defined as being insensate at two or more sites.
In their study of the technique in 265 diabetic patients, they instructed examiners not to push, prod, tap or poke. With eyes closed, subjects were instructed to say yes whenever they felt the touch.
The study found “almost perfect agreement” between the Ipswich test and 10g monofilament, using a vibration perception threshold of at least 25V. Interoperator reproducibility — assessed by repeat testing in 26 patients by a different researcher — was also strong.
The authors recommended excluding the hallux from the test, as it did not significantly improve test performance.
“The procedure is simple, reliable and quick; requires no special instruments; is easily sterilised by hand washing; and is always at hand,” they wrote.
Source: Irish Medical Times