How to Use the LEAP Monofilament

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  1. Show the monofilament to the patient and touch it to his/her hand or arm so that he/she knows it does not hurt.
  2. Use the 10 gram monofilament to test sensation at the indicated sites on each foot as shown. Apply the monofilament along the perimeter of and NOT on an ulcer, callous, scar, or necrotic tissue.
  1. Hold the filament perpendicular to the skin and use a smooth motion when testing. Use a 3 step sequence that includes (1) touch the skin, (2) bend the filament, and (3) lift from the skin.

    Do not use rapid movement. The approach, skin contact, and departure of the monofilament should be approximately 1½ seconds duration. (See Figures 1-3).

1. Touch skin 2. Bend the filament 3. Lift from the skin
  1. Ask the patient to respond "yes" when the monofilament is felt. If the patient does not respond when you touch a given point on the foot, continue on to another site. When you have completed the sequence, REPEAT the area(s) where the patient did not indicate feeling the monofilament.
  2. Use the monofilament in a random sequence.
  3. On the form, indicate with a minus sign, "—", the areas where the patient did not respond to the filament. Loss of protective sensation at any one of the eight sites indicates a foot at high risk.
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