A cross-sectional study of paper grip test as an additional test for early-stage screening of the feet in patients with diabetes
Keywords:
Paper Grip test, Semmes – Weinstein Monofilament, Foot sensations, intrinsic muscle weaknessAbstract
Introduction: Studies have shown that foot deformities such as claw foot, hammer toes can occur due to paralysis of intrinsic muscles of the feet which in turn pose a high risk for foot ulcerations, gait disturbances and falls alongside decreased sensations of the foot. Current guidelines for the screening of diabetic foot involves testing for sensations of the foot by the Semmes Weinstein Monofilament (SWM) test but testing for intrinsic muscle weakness is not done routinely. Based on available literature, onset of structural changes of the foot occurs earlier than loss of sensations hence this study was undertaken to identify intrinsic muscle weakness of the feet using a simple, test called Paper Grip test (PGT) in diabetics with normal sensations of the feet. Methodology: An analytical cross-sectional study was conducted in JSS Hospital from November 2018 to September 2020 involving diabetic patients visiting Medicine OPD and admitted patients meeting inclusion criteria of this study. Necessary ethical clearance from the institutional ethics committee of JSS medical college was obtained. Functional status of intrinsic muscles of the foot was tested by PGT and the sensations of the sole of the foot was assessed by SWM.
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