産業医学および健康問題

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A Novel Method of Monofilament Force Testing for Nerve Sensory Loss in Telemedicine

Alchemy J, Artz J, Bolon B, Arogundade O, Benson M and Pearson Z

Introduction: Conventional neuropathy testing requires providers to test patients using standardized monofilaments in clinic. If patients could reliably test their own nerve sensory capacity, diagnosis of neuropathy could occur quickly and inexpensively via telemedicine.

Such a novel, unprecedented method of remote monofilament neuropathy testing empowers telemedicine providers and patients to obtain diagnoses without a physical visit, while also creating opportunities for stakeholders to economize in workers’ compensation claims, personal injuries, and other administratively benefited injuries involving impairment rating guidelines such as the AMA Guides to the Evaluation of Permanent Impairment.

This study examines the viability of using “angel hair” pasta noodles, a material readily available to patients, as a telemedical alternative to monofilaments currently used in neuropathy testing in brick and mortar clinic.

Methods: Angel hair noodles were tested to determine the ideal conditions for breaking a noodle when 10 grams of pressure is applied. The bending point of monofilaments was tested for comparison.

Results: 23 cm Barilla angel hair noodles have an average breaking point of 10.39 g with a standard deviation of 0.78 g. The standard clinical monofilaments tested have an average bending point of 10.13 g with a standard deviation of 0.36 g.

Discussion: While the clinical monofilaments tested have a bending point closer to 10 g than the noodles, the noodles are within the acceptable error range of 10% reproducibility accepted by the AMA Guides to the Evaluation of Permanent Impairment. Testing with noodles has a comparable degree of accuracy to testing with monofilaments. Noodles may serve as a reliable alternative to monofilaments for telemedical neuropathy testing.