Introduction to the Neurosensory and Motor Testing Utilizing the Pressure-Specified Sensory Device™

The Pressure-Specified Sensory Device™ has the range and resolution to measure the magnitude of forces and pressures applicable to human sensory perception, without placing needles or electricity in the body.  This computer assisted instrument not only documents one-point sensibility of the patient, but also measures pressure thresholds at two-point discrimination to document the innervation density of the nerve.  This testing has been proven to be “better than” the functional equivalent or, emg/ncv testing, for certain indications.  It does not replace emg testing, and if the patient has cervical involvement, they would need and electrical test, however in the absence of cervical involvement, this test will provide better information, earlier information, and information that can allow you to better care for the patient.

This test is more sensitive than electrodiagnostic testing, in the hands, at the elbow and in the feet, and unlike NCV testing; it is non-invasive test that is painless for the patient.  The results correlate with the patients’ symptoms, and provide the physician with information they are not able to obtain with any other test.  The printed graph and text results are easy to interpret.

The PSSD™ replaces the need to perform Semmes- Weinstein nylon monofilaments testing or classis two-point discrimination testing.  From engineering and scientific points of view, the devices and the measurements produced are unparallel in reliability and validity, allowing for a high degree of confidence in the results.  The testing is cleared by the FDA, and approved by the National Institute of Science and Technology. 

The testing allows you to perform repetitive testing over a period of time to monitor the change in nerve function as a result of disease or treatment.  While the American Diabetes Association recommends that each patient have a sensory test each year, prior to the availability of this testing technique, standard techniques, and/or nerve conduction studies were often not successful in detecting sensory loss at a stage of the disease early enough to successfully intervene. This testing can

identify the earliest onset of neuropathy, and further provides accurate reproducible measurements to document and track even subtle sensory loss or return.  Since the test measures nerve regeneration you can test patients after surgery to document the result.

The primary uses of this test are for diabetic neuropathy, neuropathy of unknown etiology, nerve damage associate with thyroid disease, chemotherapy induced neuropathy, certain vitamin deficiencies, rheumatoid arthritis, scleroderma, lupus, alcoholism, nerve entrapment disorders such as; tarsal tunnel, and carpal tunnel syndrome, and the diagnosis of nerve injury associated with trauma.  It can help you identify and differentiate between recurrent carpal tunnel syndrome, from pronator syndrome or radial sensory nerve impairment.  It can help diagnose thoracic outlet syndrome The Digit-Grip Device™ will help you identify malingering.  The test will help evaluate difficult clinical problems such as;

Tarsal Tunnel syndrome vs. Morton’s Neuroma, Plantar Fasciitis vs. Calcaneal Nerve.  In addition the use of this devise is becoming the standard of care in limb lengthening centers, allowing for the early detection of and prevention of nerve damage associated with this type

procedure. Tarsal Tunnel syndrome vs. Morton’s Neuroma, Plantar Fasciitis vs. Calcaneal Nerve.  In addition the use of this devise is becoming the standard of care in limb lengthening centers, allowing for the early detection of and prevention of nerve damage associated with this type of procedure.

Possibly the most impressive results of the use of this testing to date have been in the treatment of patients with diabetes, making this an important modality in the daily practice of podiatric medicine and surgery.  Two studies completed by Dr. Dellon, one in 1989 and the other in 1996 involving diabetics who had been diagnosed at an early stage of nerve damage utilizing Neurosensory testing with PSSD™, and who subsequently underwent appropriate surgical decompression of the involved nerves of the lower extremity were followed post operatively.  NONE of these patients required hospitalization for the treatment of foot infections, or went on to develop foot ulcers, or required amputations.  In both of these studies patients whose un-operated extremities were retested, nerve damage progressed unabated.  Current research indicates approximately 80% of diabetic patients, who are candidates for this treatment experience significant improvement in their systems of neuropathy with reduction of pain and numbness following surgery.  This coupled with the ability to prevent major foot ulcerations, infections and associated hospitalizations and amputations represent a major advancement in the management of this difficult disease.

There are currently more than 60 scientific papers published utilizing this equipment.  Please contact us directly for more information.