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Hi,
Can you tell me whether it is current practice to check for reflexes when completing a diabetic neurovascular assessment and if so, why?
I thought that checking pedal pulses, (sometimes ABPI or toe pressures if needed) and monofilmanent and tuning fork would be enough to determine any diabetic changes?

Thank you!!

Lucy

 

HI Lucy

In my practice I always test reflexes. However I maybe an oddity as I work in a govt post acute clinic where we use a holistic multid approach to care. I work with physio, OT, EP, diab ed, nursing, diet, pharm and a social worker.

Often if reflexes are absent its indicates we have to look further into the reason why. Alot of neurological conditions, some endocrinology related conditions and some musculoskeletal conditions have lack of reflexes associated with them.

There can then be impacts on the person's gait from changes associated with muscle wasting, or lack of muscle tone for example.

Since my client load is chronic disease related, I see alot of peripheral neuropathy, autonomic neuropathy, and other conditions associated with changes in the nervous system - for example CIDP (chronic inflammatory demyelinating polyneuropathy).

So again yes I do test, but I might not be a good example of the "everyday" Podiatrist situation.