Monofilament 5.07 - 10gram
According to the American Diabetes Association, all patients with
diabetes should be screened for loss of protective sensation in their
feet (peripheral neuropathy) when they are diagnosed and at least
annually thereafter, using simple clinical tests such as the
Semmes-Weinstein monofilament exam.
The Semmes-Weinstein 5.07 monofilament nylon wire exerts 10 g of force
when bowed into a C shape against the skin for 1 second. Patients who
can’t reliably detect application of the 5.07, 10-g monofilament to
designated sites on the plantar surface of their feet are considered to
have lost protective sensation.
1. Place the patient in supine or sitting position with shoes and socks removed.
2. Tell the patient that you’re testing for loss of protective sensation, which increases the risk of foot ulcers and amputation.
3. Touch the 5.07 monofilament wire to the patient’s skin on the arm or hand to demonstrate what the touch feels like.
4. Instruct the patient to respond “Yes” each time he or she feels the pressure of the monofilament on the foot during the exam.
5. Instruct the patient to close his or her eyes and keep toes pointing straight up during the exam.
6. Hold the monofilament perpendicular to the patient’s
foot. Press it against the foot, increasing the pressure until the
monofilament bends into a C shape. (The patient should sense the
monofilament by the time it bows.)
7. Hold the monofilament in place for about 1 second.
Press the monofilament to the skin so it buckles at one of two times as
you say “Time one” or “Time two.” Have the patient identify at which
time he or she was touched. Randomize the sequence of applying the
filament throughout the examination.
8. Locations for testing: On both feet, use the first,
third, and fifth metatarsal heads and plantar surface of the distal
hallux and third toe (see diagram). Avoid callused areas.
9. Record response on foot screening form with “+” for Yes and “–” for No.