About the Touch-Test

Sensory Evaluators (Semmes-Weinstein Monofilaments) provide a non-invasive evaluation of cutaneous sensation levels throughout the body with results that are objective and repeatable.

Using Touch-Test

Sensory Evaluators is indicated in diagnoses including nerve compression syndromes, peripheral neuropathy, thermal injuries and

postoperative nerve repair. Each Touch-Test Sensory Evaluator is individually calibrated to deliver its targeted force within a 5% standard deviation.

1. Rest the patient’s extremity on a stable, padded surface. Testing should be done in a quiet area to help the patient fully attend to the testing procedure. Occlude the patient’s vision by using a shield or by having the patient look away.

2. Explain the testing procedure to the patient and instruct the patient to respond when the stimulus is felt by saying “touch” or “yes”. Nonverbal patients may tap the table lightly when the stimulus is felt.

3. Note any areas of callus, abrasion, scarring or other blemishes by drawing on the recording form (Hand Screening Form or Foot Screening Form). While testing, proceed from distal to proximal and from small to large monofilaments.

4. It is not necessary to test every area of the skin when performing an evaluation. Checks may be done over areas innervated by different nerves. For the hand, test the palmar surface of the index finger and thumb to evaluate median nerve function; test the little finger and hypothenar eminence to evaluate the ulnar nerve; and test the dorsum of the hand to evaluate the radial nerve (see Figure 1). For the foot, test the sites indicated in Figure 2.

5. Press the filament at a 90° angle against the skin until it bows. Hold in place for 1.5 seconds and then remove (see Figure 3). For monofilaments from 1.65 to 4.08 apply the stimulus in the same location up to three times to elicit a response. A single response indicates a positive response. For filaments 4.17 through 6.65, apply the stimulus one time only.

6. To test with the Touch-Test 5 Piece Hand Kit, the Touch-Test Six Piece Foot Kit or the Touch-Test 20 Piece Full Kit, begin with the 2.83 filament. If the patient responds to the stimulus in all sites, normal cutaneous sensation can be documented and the examination is completed. If the patient does not respond to the stimulus, choose the next largest monofilament and repeat the process.

7. When the patient indicates a response, record the result using the colored pencil that corresponds to the color on the handle of the Touch-Test Sensory Evaluator (Colored Pencils Set). When representing monofilaments of the same color, notate which monofilament size was used (see Figure 4). Threshold levels indicated in Figure 5 can be used to interpret test results.

*If testing with the 5.07 only, follow instructions #1- #5. Then apply the 5.07 to the test sites shown in Figure 2. Record results using a to indicate each site with sensation and for lack of sensation.