Examining practice effects in repeated measurements of vibration perception thresholds on finger pulps of healthy individuals – Is it possible to improve your results over a clinically relevant test interval?

Autoři: Linnéa Ekman aff001;  Jin Persson Löfgren aff001;  Lars B. Dahlin aff001
Působiště autorů: Department of Translational Medicine—Hand Surgery, Lund University, Malmö, Sweden aff001;  Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226371



To investigate practice effects in a test-retest situation, where vibration perception thresholds (VPT) were measured in healthy subjects using a multi-frequency test method.


In eight consecutive tests, VPTs were tested in the pulps of the index and little fingers at seven frequencies (8, 16, 32, 64, 125, 250 and 500 Hz). Subjects were twenty healthy adults aged 26 to 65 years (mean 46.0 ± 11.1 years; 10 male and 10 female). The subjects were examined at six tests with intervals of one month (mean 33 ± 6; time 0 to month 5) and at two additional tests with prolonged intervals (month 12 and 18). Linear mixed model analysis was performed to investigate differences over the subsequent test occasions. To examine where potential practice effects occurred, a pairwise comparison with Bonferroni correction was made.


Small decreases in VPTs were found in 8 out of the 14 frequencies (index finger: 8, 16, 32, 250 and 500 Hz; little finger: 16, 250 and 500 Hz) within the test period from time 0 to month 5. In tests at 12 and 18 months, VPTs were increased compared to month 5, but lowered in comparison with time 0. Hence, minor significant decreases were found in three frequencies for the index finger (125, 250 and 500 Hz) and one frequency for the little finger (250 Hz) when examining VPTs with prolonged time intervals.


When evaluating vibration perception thresholds in a clinically relevant time period of once or twice a year, no consideration of practice effects is necessary when interpreting the results.

Klíčová slova:

Equipment – Mechanoreceptors – Neuropathy – Peripheral neuropathy – Tactile sensation – Vibration


1. LaMotte RH, Mountcastle VB. Capacities of humans and monkeys to discriminate vibratory stimuli of different frequency and amplitude: a correlation between neural events and psychological measurements. J Neurophysiol. 1975;38(3): 539–59. doi: 10.1152/jn.1975.38.3.539 1127456

2. Mountcastle VB, LaMotte RH, Carli G. Detection thresholds for stimuli in humans and monkeys: comparison with threshold events in mechanoreceptive afferent nerve fibers innervating the monkey hand. J Neurophysiol. 1972;35(1): 122–36. doi: 10.1152/jn.1972.35.1.122 4621505

3. Johnson KO. The roles and functions of cutaneous mechanoreceptors. Curr Opin Neurobiol. 2001;11(4): 455–61. doi: 10.1016/s0959-4388(00)00234-8 11502392

4. Hilz MJ, Axelrod FB, Hermann K, Haertl U, Duetsch M, Neundörfer B. Normative values of vibratory perception in 530 children, juveniles and adults aged 3–79 years. J Neurol Sci. 1998;159(2): 219–25. doi: 10.1016/s0022-510x(98)00177-4 9741411

5. Duke J, McEvoy M, Sibbritt D, Guest M, Smith W, Attia J. Vibrotactile threshold measurement for detecting peripheral neuropathy: defining variability and a normal range for clinical and research use. Diabetologia. 2007;50(11): 2305–12. doi: 10.1007/s00125-007-0813-y 17846743

6. Dahlin LB, Güner N, Elding Larsson H, Speidel T. Vibrotactile perception in finger pulps and in the sole of the foot in healthy subjects among children or adolescents. PLoS One. 2015;10(3): e0119753. doi: 10.1371/journal.pone.0119753 eCollection 2015. 25835710

7. Meier PM, Berde CB, DiCanzo J, Zurakowski D, Sethna NF. Quantitative assessment of cutaneous thermal and vibration sensation and thermal pain detection thresholds in healthy children and adolescents. Muscle Nerve. 2001;24(10): 1339–45. doi: 10.1002/mus.1153 11562914

8. Louraki M, Tsentidis C, Kallinikou M, Kanaka-Gantenbein C, Kafassi N, Papathanasiou A et al. Reproducibility of vibration perception threshold values in children and adolescents with type 1 diabetes mellitus and associated factors. Prim Care Diabetes. 2014;8(2): 147–57. doi: 10.1016/j.pcd.2013.11.002 24315733

9. Cederlund RI, Thomen N, Thrainsdottir S, Eriksson KF, Sundkvist G, Dahlin LB. Hand disorders, hand function, and activities of daily living in elderly men with type 2 diabetes. J Diabetes Complications. 2009;23(1): 32–9. doi: 10.1016/j.jdiacomp.2007.09.002 18413154

10. Dahlin LB, Granberg V, Rolandsson O, Rosén I, Dahlin E, Sundkvist G. Disturbed vibrotactile sense in finger pulps in patients with Type 1 diabetes–correlations with glycaemic level, clinical examination and electrophysiology. Diabet Med. 2011;28: 1045–52. doi: 10.1111/j.1464-5491.2011.03328.x 21843302

11. Hubbard MC, MacDermid JC, Kramer JF, Birmingham TB. Quantitative vibration threshold testing in carpal tunnel syndrome: analysis strategies for optimizing reliability. J Hand Ther. 2004;17(1): 24–30. doi: 10.1197/j.jht.2003.10.004 14770135

12. Thomsen NO, Cederlund R, Speidel T, Dahlin LB. Vibrotactile sense in patients with diabetes and carpal tunnel syndrome. Diabet Med. 2011;28(11): 1401–6. doi: 10.1111/j.1464-5491.2011.03308.x 21480975

13. Garrow AP, Boulton AJ. Vibration perception threshold—a valuable assessment of neural dysfunction in people with diabetes. Diabetes Metab Res Rev. 2006;22(5): 411–9. doi: 10.1002/dmrr.657 16741996

14. Boulton AJ, Vinik AI, Arezzo JC, Bril V, Feldman EL, Freeman R et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4): 956–62. doi: 10.2337/diacare.28.4.956 15793206

15. Gerr F, Hershman D, Letz R. Vibrotactile threshold measurement for detecting neurotoxicity: reliability and determination of age- and height-standardized normative values. Arch Environ Health. 1990;45(3): 148–54. doi: 10.1080/00039896.1990.9936708 2167042

16. Valk GD, Grootenhuis PA, van Eijk JT, Bouter LM, Bertelsmann FW. Methods for assessing diabetic polyneuropathy: validity and reproducibility of the measurement of sensory symptom severity and nerve function tests. Diabetes Res Clin Pract. 2000;47(2): 87–95. doi: 10.1016/s0168-8227(99)00111-4 10670907

17. Ising E, Dahlin LB, Elding Hansson H. Impaired vibrotactile sense in children and adolescents with type 1 diabetes–Signs of peripheral neuropathy. PLoS One 2018;13(4): e0196243. doi: 10.1371/journal.pone.0196243 eCollection 2018. 29672623

18. Rubino A, Rousculp MD, Davis K, Wang J, Bastyr EJ, Tesfaye S. Diagnosis of diabetic peripheral neuropathy among patients with type 1 and type 2 diabetes in France, Italy, Spain, and the United Kingdom. Prim Care Diabetes. 2007;1(3): 129–34. doi: 10.1016/j.pcd.2007.07.006 18632033

19. Candrilli SD, Davis KL, Kan HJ, Lucero MA, Rousculp MD. Prevalence and the associated burden of illness of symptoms of diabetic peripheral neuropathy and diabetic retinopathy. J Diabetes Complications. 2007;21(5): 306–14. doi: 10.1016/j.jdiacomp.2006.08.002 17825755

20. Van Acker K, Bouhassira D, De Bacquer D, Weiss S, Matthys K, Raemen H et al. Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics. Diabetes Metab. 2009;35(3): 206–13. doi: 10.1016/j.diabet.2008.11.004 19297223

21. Strömberg T, Dahlin LB, Lundborg G. Vibrotactile sense in the hand-arm vibration syndrome. Scand J Work Environ Health. 1998;24(6): 495–502. doi: 10.5271/sjweh.374 9988092

22. Gelber DA, Pfeifer MA, Broadstone VL, Munster EW, Peterson M, Arezzo JC et al. Components of variance for vibratory and thermal threshold testing in normal and diabetic subjects. J Diabetes Complications. 1995;9(3): 170–6. doi: 10.1016/1056-8727(94)00042-m 7548981

23. Fagius J, Wahren LK. Variability of sensory threshold determination in clinical use. J Neurol Sci. 1981;51(1): 11–27. doi: 10.1016/0022-510x(81)90056-3 7252516

24. van Deursen RW, Sanchez MM, Derr JA, Becker MB, Ulbrecht JS, Cavanagh PR. Vibration perception threshold testing in patients with diabetic neuropathy: ceiling effects and reliability. Diabet Med. 2001;18(6): 469–75. doi: 10.1046/j.1464-5491.2001.00503.x 11472466

25. ISO 1309–1. Mechanical vibration–Vibrotactile perception thresholds for the assessment of nerve dysfunction–Part 1: Methods of measurement at the fingertips. International Organization of Standardization, Geneva; 2001.

26. Guyatt G, Walter S, Norman G. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis. 1987;40(2): 171–8. 3818871

27. Wu JZ, Krajnak K, Welcome DE, Dong RG. Analysis of the biodynamic interaction between the fingertip and probe in the vibrotactile tests: the influences of the probe/fingertip contact orientation and static indentation. J Biomech. 2009;42(2): 116–24. doi: 10.1016/j.jbiomech.2008.10.033 19110251

28. Dahlin LB, Thrainsdottir S, Cederlund R, Thomsen NO, Eriksson KF, Rosén I et al. Vibrotactile sense in median and ulnar nerve innervated fingers of men with Type 2 diabetes, normal or impaired glucose tolerance. Diabet Med. 2008;25(5): 543–9. doi: 10.1111/j.1464-5491.2008.02433.x 18346156

29. Thomsen NO, Englund E, Thrainsdottir S, Rosén I, Dahlin LB. Intraepidermal neve fiber density at wrist level in diabetic and non-diabetic patients. Diabet Med. 2009; 26(11): 1120–6. doi: 10.1111/j.1464-5491.2009.02823.x 19929990

30. Whitehouse DJ, Griffin MJ. A comparison of vibrotactile thresholds obtained using different diagnostic equipment: the effect of contact conditions. Int Arch Occup Environ Health. 2002;75(1–2): 85–9. doi: 10.1007/s004200100281 11898881

Článek vyšel v časopise


2019 Číslo 12