Neurosensory Analyzer

A modern medical diagnostic device for early diagnosis of nerve fibre damage using computer pallestesiometry ( vibration sensitivity) methods.

 
 

Neurosensory Analyzer “Vibrosensotest”is designed for early diagnosis of the symptoms of peripheral neuropathy and polyneuropathy. The device uses  computer pallestesiometry methods in accordance with the international standard ISO 13091: 2001.

 

Application

Vibration disease – early diagnosis of occupational diseases in industries where employees work is associated with machines and power tools.

Diabetes mellitus - diagnosiss and the measurement of the effectiveness of treatment of peripheral neuropathy symptoms.

Peripheral polyneuropathies of any origin, central and peripheral pain syndromes, autoimmune diseases.

Spheres of application:

Preventitive Medicine, occupational health, screening of employees for occupational diseases, endocrinologic and neurologic profiles. Staff pre appointment health checks and Health and Safety monitoring of staff using machines and power tools.

Capabilities of the unit:

- early detection of sensitivity disorders  in patients with peripheral neuropathies of limbs of different origins;

- identifying the presence and  extent of  thick myelinated A-beta type nerve fibres;

- identifying the presence and  extent of thin non-myelinated C type nerve fibres;

- identifying the presence and extent of thin non-myelinated of A-delta type nerve fibers;

 

Advantages

The unit complies with the International and Russian standard for peripheral neuropathy registration GOST R ISO 13091-1: 2008 (ISO 13091:2001).

A unique patented vibrator design which eliminates false readings when applying different vibration frequencies to the area being examined, when it is placed onto  the vibropusher.

Generation of stimulation signals at a  “pure tone”absence of rogue tones and distortions.

Ergonomic design of the support stand for upper and lower limbswhich allows muscles to fully relax which improves diagnostic accuracy.

The forming of stimuli at the exact frequency and amplitude in both hand and automatic mode.

Integrated recording methods for:

- slow adapting of type I (SAI) mechanoreceptors;

- fast adapting type I and II (FAI, FAII mechanoreceptors);

- user-friendly software with the capability of building vibrogram, study result tables, generation of treatment techniques and reports, database management of patient examination records.z

 

Main technical characteristics 

Standard frequencies for determination of the thresholds of vibrotactile sensitivity in accordance with GOST R ISO 13091- 1:2008

3.15; 4.0; 5.0; 20; 25; 31.5; 100; 125; 160 Hz

Additional frequencies for determination of the vibrotactile sensitivity thresholds in the range of

3-500 Hz

Vibrotactile stimulator accuracy

At least 0.05 Hz

Vibrotactile stimulator signal

“Sinus” “Meander”

Lower limbs support stand

Optional*

Operation mode

Auto/Hand

Basic methods of diagnostics

“Occupational diseases”, “Diabetic neuropathy”

Methods for slow adapting mechanoreceptors

SAI

Methods for fast adapting mechanoreceptors

FAI,FAII

Data visualization

Tables, vibrogram, histograms

 

 

Polyneuropathies are one of the greatest factors in somatic disease complications. In the pathogenesis of the different forms of neuropathies (diabetic, genetic, alcoholic, medicamentous etc.) one of the early symptoms in the phase when medicamentous correction is most effective, is the condition of vibration sensitivity due to the damage of thick sensory A-beta type fibres since it was proved that the given type of sensitivity may decrease long before the emergence of other neuropathy symptoms. 

 

Prior to the development of computer pallestesiometry, vibration sensitivity was studied using tuning forks tuned at a frequency of 128 Hz. Such an approach to diagnosis was limited and inaccurate. The studies conducted testified that for early diagnostics and prevention of diseases it is necessary to us a wider spectrum of frequencies to assess the full  vibrational impact. 

Vibrotactile sensitivity is determined by the combination of nervous activity of up to 4 populations of specific nerve endings. It is common practice to classify mechanoreceptors by the particulates of their perception of the skin area sagging parameters (for example, SAI: slow adapting mechanoreceptors of type I); SAII: slow adapting mechanoreceptors of type II; FAI: fast adapting mechanoreceptors of type I;  fast adapting mechanoreceptors of type II). If the receptors SAII react in the first place to the skin surface area extension, then the responses from the other 3 mechanoreceptor populations: SAI, FAI and FAII, if the measurement conditions were selected correctly, can be differentiated by the use of the different vibrotactile impact frequencies.

So, for the recording of the responses from slow adapting type SAI mechanoreceptors, the stimulation frequencies range is 3-5 Hz; for the recording of the responses from fast adapting type FAI and FAII mechanoreceptors the ranges to use are 20-31 and 100-160 Hz respectively.

Currently VIBROTESTER “VIBROSENSOTEST-STM” is the only unit fully compliant with the requirements of GOST R ISO 13091- 1:2008 (Fig.1.).).

It is well known, that the key factor in validation of testing of both diagnostic and screening tests is the ability to compare the study results obtained on various diagnostic instruments.

In this regard, the methods of study and estimation of the vibrotactile sensitivity dysfunction is set out in the standard (ISO 13091-1:2003 or GOST R ISO 13091-1:2008). This standard establishes the methods of vibrotactile sensitivity threshold measurements on the fingertips, the analytical tools and methods of analysis and presenting the results of the measurements. The measurement methods are suitable for both healthy persons and persons suffering from diseases and can be used both in clinical practice and medical screening checks.

 

The standard GOST R ISO 13091- 1:2008 defines a range of requirements to the computer pallestesiometry units

 

*TThe stimulating impulse needs to be either a pure continuous tone or discontinuous signal in the form of tone bursts (the impulse should contain at least a half of the sinusoid).

*The requirements of the position of a subject during measurements. During the testing the forearm should be stretched to full length; the hand and the finger on which the pusher makes the impact should rest on the support stand.  

 

The hand position should be as near to neutral as is possible. The level of concentration and motivation of a subject have an effect level of concentration and motivation of the person being tested have an effect on the accuracy of measurements and the replication of results. Any distractions, including factors causing a subject’s discomfort, should be excluded. Possible finger positions are presented in Fig. 2.

 

*Care must be taken that the pusher is not in contact with thickened skin areas. This can be achieved by ensuring that the central axis of the pusher is positioned on the finger tip, near to the finger bone at the tip of the finger and aligned to the whorl of the finger print. Measurement taken in a callused areas or in affected skin areas (i.e. having clearly visible scars, burns or wounds) will neither be accurate nor reliable for diagnostic purposes.

*The background vibration level on each measurement frequency should not exceed the minimum sensitivity threshold on the frequency.

*The terminal end of the stimulator pusher is shaped like a cylinder with a flat side. And has a base diameter of 4.0±2.1 mm. The cylinder base which is in contact with the skin should be positioned parallel to it so that the vibration is directed perpendicular to the area.

*The area of the finger skin in contact should be 1.5±0.8 mm.

Technical features

The device design contains a unique patented vibrator system which helps to exclude false readings during different frequencies or vibrations on the vibropusher.

Generation of stimulation signals occurs in “signal” or “pure tone” which eliminates  rogue tones and distortions arising with “meander’ signal. Thus, the patient exposure is optimally accurate. An ergonomic design of the support stand for upper and lower limbs (Fig.3) makes it possible to fully relax muscles and improve diagnostics accuracy.

The forming of stimuli at precise frequency and amplitude in hand and automatic mode allows for accurate adjusting of the unit operation for the purposes and tasks of an examination.

Integrated recording techniques for:

- slow adapting receptors of 1 type (SAI);

- fast adapting receptors of 1 and 2 type (FAI,FAII).

Integrated guidelines for different age groups.

Wizard for random diagnostic and examination techniques, including Shnaider N.A. techniques.

User friendly software with the functions of constructing diagrams, examination result tables, technique and report formation, examination and patient data base management.

 

Application 

 

 

Vibration disease – early diagnosis of occupational diseases in industries where work is associated with machines and power tolls.

Diabetes mellitus - diagnostics and the control of the treatment and monitoring of progress of peripheral neuropathy symptoms. 

Peripheral polyneuropathies of any origin, central and peripheral pain syndromes, autoimmune diseases.

Area of application:

Preventative Medicine, Occupational Health, Health and safety monitoring and risk assessment of employees using machines and power tools, screening for occupational diseases , endocrinologic and neurologic profiles. Employee Screening for pre employment and damage assessment. 

Capabilities of the unit:

- early detection of sensation disorders  in patients with peripheral neuropathies of limbs of different origin;

- screening-estimate of the state of thick myelinated of A-beta type nerve fibers;

- screening-estimate of the state of thin non-myelinated C type nerve fibers;

- screening-estimate of the state of thin non-myelinated A-delta type nerve fibers;

 


The complex is for recording and analysis of vibrotactile sensitivity.

Technical characteristics

1.

Recorded frequencies of vibrotactile sensitivity per GOST 13091-1-2008

3.15; 4.0; 5.0; 20; 25; 31.5; 100; 125; 160 Hz.

2.

Non-standard frequencies

8,16,32,63,1225,250,500.

3

Capability of random stimulation frequency setting

available

4

Stimulation frequency setting accuracy

At least 1%

5

Patient vibrosensitivity detector signal waveform

Sinus, meander

6

Voltage setting increment, DB

0.5; 0.75; 1

7

Automatic measurement mode

available

8

Hand measurement mode

available

9

Capability of creating user-specific vibrotactile sensitivity recording techniques

available

10

Slow adapting type 1 (SAI) receptors recording technique

available

11

Fast adapting type 1 (FAI) receptors recording technique

available

12

Fast adapting type 2 (FAII) receptors recording technique

available

13

Native vibrosensitivity graphic display

available

14

Measurement analysis graphic display

available

15

Measurement analysis table construction

available

16

Measurement analysis histogram construction

available

17

Automatized measurement report

available

18

Patient database management

available

19

Export of analysis data to MSWord, OpenOffice

available

20

Data and report printout

available

21

Software enabling integration into the healthcare center information system

available

Standard supply package

1

Vibrotactile sensitivity recording unit

1-2 pcs

2

Patient foot stand

optional

3

Power unit

1 pcs

4

Autonomous control unit with touchscreen or PC

1 pcs

5

Printout device

optional

 

Infrared non-contact thermometer

optional

 

Noise absorption headphone

optional

6

Software package

package

7

Operation manual

package

8

Methodological recommendations

package

 

*The technical capabilities and the power supply can be changed to meet customer specifications. Please contact us with your specific requirements.