The Rydel Seiffer tuning fork - Age and gender matter

Abstract

Background: The Rydel Seiffer tuning fork (RSTF) can be easily applied to evaluate deficits of vibration perception. Standard normative data as stated in textbooks (6/8-thresholds among the "elderly") is not suitable for an informed decision-making process.

Objective: To reevaluate the range of vibration detection thresholds (VDT) based on assessments in healthy Caucasians stratified for age and gender using the RSTF and on a short-review of literature on normative data on PubMed.

Methods: Monocentric, prospective assessment of VDT at the dorsal 1st metatarsophalangeal joint of both sides in 77 healthy volunteers. Participants were grouped according to age: 20-39 years (group I, n = 24), 40-59 years (group II, n = 29), 60-79 years (group III, n = 24). Data was stratified for gender. Means were compared via Mann-Whitney U-test; correlations were rated via Pearson correlation coefficient. A short-review of literature was performed on PubMed.

Results: Aging related to declined vibration perception (r = -0.446, p < 0.001). Women aged 60 years and older showed better vibration perception compared to men (men: 6.5 ± 1.3, women: 7.5 ± 0.9, p = 0.003). All VDT-limits were higher compared to results gathered in literature (I: 7.9 ± 0.3, II: 7.7 ± 0.5, III: 7.1 ± 1.1). Formerly reported VDT-limits at the lower limbs were scattered (e.g., >4.5/8 to ≥6.6/8 at age 18-29). Current data, especially VDT of participants aged 50 years and older, were largely in line with data reported by Hilz et al. 1998: 18-29 years: ≥ 6.6/8, 30-39 years: ≥ 5.5/8, 40-49 years: ≥ 5.7/8, 50-59 years: ≥ 5.4/8, 60-69 years ≥ 5.2/8, > 70 years ≥ 5.3/8, alternative: 30-39 years ≥ 6.2/8 Magerl et al. 2010. Data on diagnostic sensitivity by Xirou et al. 2020 supported a VDT-limit of 5.9/8 across all ages to aim for high sensitivity. A better vibration perception among elder women compared to men has been described by many studies.

Discussion: The current data and literature underline, that higher VDT-limits stratified for age and gender should be considered in a clinical setting. Until further validation within larger samples, we propose to consider the limits as reported by Hilz et al. 1998. Furthermore, women at age 60 + years presenting with borderline thresholds should be considered for further diagnostic workup.