Do standard neurological assessments tell us more than we realise?

Abstract Background Neurological assessments are commonly performed by podiatrists as a screening tool for peripheral neuropathy, and to identify the risk of foot ulceration and amputation. Monofilament and tuning fork assessments are routinely used to assess peripheral sensation. Whilst these assessments are commonly used to monitor foot health, there is potential for neurological results to illuminate a broader and more holistic perspective of a person’s overall health status. Methods Recruitment of fifty participants (31 female, 19 male; 71.78±9.64 years) for foot health screening was associated with a foot health week promotional event at the Charles Sturt University Community Engagement and Wellness Centre. Under the guidance of registered podiatrists, fourth year podiatry students completed basic neurological assessments to determine each participant’s neurological status. Participants also completed a modified Foot Health Status Questionnaire (FHSQ). Age and monofilament results were analysed using Spearman’s rho, while correlations involving FHSQ data were identified using a Kruskal-Wallis test. Results For those participants who reported an excellent rating of their own health, there was a statistically significant relationship with adequate vibration sensation (p<0.01). A person’s ability to get up from a sitting position (p<0.01), lift and carry shopping (p=0.02) and climb a flight of stairs (p=0.03), was significantly correlated with more sites detected using monofilament assessment. Discussion Significant correlations were observed between basic neurological assessments and a number of activities of daily living. While the findings reflect a correlational relationship, not causational, this still provides an opportunity for clinicians to view neurological assessment results more holistically. Whilst the immediate focus for a practitioner will be tissue viability, neurological findings may be useful to stimulate further discussion about a patient’s functional capacity by exploring issues beyond the presenting condition.