Preparation for the Test

1. Wash hands prior to administering the test.
2. Instruct the patient to remove their shoes and socks.
3. Position the patient sitting on a table with feet hanging over the end of the table.
4. Explain the test to the patient so they understand the “what” and “why” of the monofilament sensory test.
5. Demonstrate the test by applying the monofilament strand perpendicular to the patient’s palm, finger, and/or arm in similar manner in which it will be conducted when applied to the foot.
6. Instruct the patient to lie down and to not watch the test as it is conducted, as it is a sensory perception test without visual feedback.
7. Instruct the patient to respond with a verbal “yes” or signal with a “raised hand” when they feel the monofilament being pressed against their foot.

Conducting the Test

1. Reference the Diabetic Neuropathy Monofilament Foot Screen for the sites where the monofilament will be applied as part of the 10 site Monofilament Test.
   
2. Hold the monofilament device so it is perpendicular to the skin where the test will be performed. Then follow these three sequential steps:

• Touch the skin with the monofilament strand
• Smoothly apply sufficient force to cause the strand to bend into a curve, and hold that position for approximately ½ to 1 second
• Lift the monofilament strand away from the skin

     3. Documentation:  Place a “+” in the site circle when the patient responds “yes”, and a “-“ in the site circle if the patient does not respond to a test site. 

    4. Important:

• The pace of administering the testing – moving from site to site – should vary so that the patient does not “anticipate” when the test is being conducted.
• Testing should move randomly from site to site so that a recognized and anticipated pattern is not developed.
• If during the testing the patient does not respond to a specific site, continue on to the next site uninterrupted. At conclusion of the testing (all 10 sites), REPEAT the test at the site or sites where the patient did not respond indicating that they felt the monofilament.
• The testing should always be conducted on both feet.

Download the Monofilament Test Form HERE.

You can purchase a Monofilament Test Kit by clicking HERE.