Isj. Merkies et al., Reliability and responsiveness of a graduated tuning fork in immune mediated polyneuropathies, J NE NE PSY, 68(5), 2000, pp. 669-671
The interobserver and intraobserver reliability of the Rydel-Seiffer (RS) g
raduated tuning fork was evaluated in 113 patients with a clinically stable
immune mediated polyneuropathy (83 patients who had had Guillain-Barre syn
drome (GBS) in the past, 22 with a chronic inflammatory demyelinating polyn
europathy (CIDP), and eight with a polyneuropathy associated with a gammopa
thy of undetermined significance). Additionally, the responsiveness of this
instrument was serially investigated in 20 patients with recently diagnose
d GBS or CIDP and changing clinical conditions. The measures were done in t
riplicate at eight different locations in the limbs and the values were com
pared with the recently published vibration threshold reference values. Goo
d interobserver and intraobserver agreements (quadratic weighted kappa=0.67
-0.98) and high responsiveness values (standardised response mean scores>0.
8) were demonstrated for the RS tuning fork. These results provide, in addi
tion to literature findings, further evidence for incorporation of this eas
ily applicable instrument in routine neurological examination.