Sharpening the tandem walking test for screening peripheral neuropathy.

Abstract:

OBJECTIVE:Few tests of functional motor behavior are useful for rapidly screening people for lower extremity peripheral neuropathy. The goal of this study was to improve the widely used tandem walking (TW) test. METHODS:We tested "normal" (control) adult and ambulatory patients with peripheral neuropathy (PN) with their eyes open and eyes closed while they performed TW on industrial carpeting in sock-covered feet. Each subject wore a torso-mounted inertial motion unit to measure kinematic data. The data of subjects with PN also were compared with historical data on patients with vestibular impairments. RESULTS:The normal and PN groups differed significantly on TW and on the number of steps completed. PN and vestibular impairments data also differed significantly on both visual conditions. Kinematic data showed that patients with PN were more unstable than normal patients in the group. For the number of steps taken during the eyes open condition, receiver operating characteristic (ROC) values were only 0.81 and for the number of steps taken during the eyes closed condition, ROC values were 0.88. Although not optimal, this ROC value is better. Sensitivity and specificity at a cutoff of two steps were 0.81 and 0.92, respectively, and at a cutoff of three steps were 0.86 and 0.75, respectively. ROC values for kinematic data were <0.8, and when combined with the ROC value for the number of steps, the total ROC value did not improve appreciably. CONCLUSIONS:Although not ideal for screening patients who may have PN, counting the number of steps during TW is a quick and useful clinical test. TW is most sensitive to patients with PN when they are tested with eyes closed.

journal_name

South Med J

journal_title

Southern medical journal

authors

Cohen HS,Mulavara AP,Peters BT,Sangi-Haghpeykar H,Kung DH,Mosier DR,Bloomberg JJ

doi

10.1097/SMJ.0000000000000009

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

565-9

issue

10

eissn

0038-4348

issn

1541-8243

pii

00007611-201310000-00005

journal_volume

106

pub_type

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