The Semmes-Weinstein Monofilament test is a sensory assessment tool. This assessment tool consists of a set of monofilaments that vary in thickness and diameter, the gradient forces of these monofilaments ranges from .086 gm to 448gm. These monofilaments are used to map out sensory loss. The results are useful in comparing the sensory loss with the return of sensations on various regions of the body. We conducted this assessment only on the hand and forearm.
The procedure in which this assessment is administered should be very systematic. The evaluator starts with the smallest monofilament and works upward towards the largest filament, but the evaluator stops testing when the smallest monofilament being tested is perceived by the client. We worked our way from digit one to digit five, distally to proximally, anteriorly to posteriorly. We then began testing the client’s volar palm and dorsal hand, which preceded the anterior then posterior forearm testing. There are diagrams present within the assessment tool that are to be colored according to sensory abilities. Green corresponds with normal sensation. Blue corresponds with diminished light touch sensation. Purple corresponds with diminished protective sensation. Red corresponds with loss of protective sensation, and red lines mean that the client was untestable in that region.
On our client’s right hand, he had normal sensation on the proximal phalange of digits one and two along with the proximal-lateral two portions of his palm on the volar side of his hand. He had diminished light touch on the distal phalanges of digits two through five, middle phalanges of digits one through four, proximal phalange of digit four, distal four portions of the palm, middle four portions of his palm, and medial-proximal portion of his palm on the volar side of his hand. He had diminished protective sensation on the middle and proximal phalanges of digit five and the distal phalange of digit one on the volar side of his hand.
Diminished Light Touch – blue
Diminished Protective Sensation – Purple
Loss of Protective Sensation – Red
Untestable – Red lines