Masumeh Bagherzadeh Cham - NeuromNeuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran. usculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical sciences, Tehran, Iran AND Department of Orthotic
Mohammad Ali Mohseni-Bandpei - Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Mahmood Bahramizadeh - Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Saeed Kalbasi - Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Akbar Biglarian - Department of Biostatistics, Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Objectives: Sensory neuropathy is the major cause of ulceration in diabetic patients. Periodical sensory examination is an appropriate method to detect neuropathy and decrease the risk of diabetic foot ulcer. Semmes–Weinstein Monofilaments (SWM) and tuning fork on/off test are widely used to assess pressure and vibration sensitivity. The present study evaluated the inter- and intra-rater reliability of SWM and tuning fork to measure pressure and vibration sensations in diabetic patients. Methods: Following ethical approval, ۳۴ diabetic patients without foot ulceration were recruited. Feet kit SWM and tuning fork were used for pressure and vibration sensation evaluation, respectively. Measurements were performed twice on the first session with an hour interval to assess within-day reliability and the third one was demonstrated ۷ days later to assess between-days reliability.  Results: Within-day Intra-class Correlation Coefficient (ICC) analysis indicated excellent levels of inter- and intra- rater reliability (ICC>۰.۷۵) for feet kit SWM in all foot regions and ۱۲۸ Hz and ۲۵۶ Hz tuning forks. Excellent between-days intra-rater reliability (ICC>۰.۷۵) was also obtained for SWM; however, the ICC of tuning fork was moderate. Between-days inter-rater reliability of SWM and tuning fork were high and poor, respectively. Discussion: The obtained results indicated that SWM and tuning fork seemed to be highly reliable to measure pressure and vibration sensations in diabetic patients. However, further studies are required to support the results of current study.

Pressure sensation, Vibration sensation, Observer variations, Diabetes Mellitus