I saved the most interesting device for testing the neurologic function in a diabetic patient until last. This topic is last because I can admit having the least experience with it, for that matter no experience. Regardless it’s one of the five recommended tests with strong evidence to advocate for it’s use in identification of lack of protective sensation in the diabetic foot.

Vibration perception threshold testing or VPT gives a semiquantatative assessment of vibration perception using a hand held biothesiometer. Testing is similar to the tuning fork test in that it’s performed over the pulp of the hallux. The amplitude of the vibration is increased until the patient can detect the vibration resulting in a VPT. A VPT is the mean of 3 readings over each hallux with a VPT >25V being regarded as abnormal.