LL Touch, Pain, Proprioception Test

LL

(Lower limb touch and pain assessment)

Sensation Sensations to be tested include light touch, pin prick, vibration, and joint position sense, or proprioception.

Light Touch Ask the patient to place their legs out straight on the bed. Lightly touch the patient’s sternum with a piece of cotton wool so that they know how it feels. With the patient’s eyes shut, lightly touch their leg with the cotton wool. The places to touch the patient should test each of the dermatomes 

Lower limb proprioception JPS

Proprioception Hold the distal phalanx of the great toe on either side so that you can flex the interphalangeal joint. Show the patient that when you hold the joint extended, that represents Up whereas when you hold it flexed that represents Down. Ask the patient to close their eyes and, having moved the joint a few times hold it in one position – up or down. Ask the patient which position the joint is in.

Lower limb proprioception (vibration)

Vibration

To assess vibration, use a sounding tuning fork. Place the fork on the patient’s sternum to show them how it should feel.

Now place the tuning fork on their great toe and ask them if it feels the same. If it does, there is no need to check any higher. If it feels different you should move to the tibial epicondyle and then to the greater trochanter until it feels normal.