The Ipswich Touch Test (IpTT) is a simple, quick, and highly practical bedside screening tool used primarily to assess peripheral neuropathy in patients, especially those with diabetes. Peripheral neuropathy is a common complication in diabetes and can lead to serious outcomes such as foot ulcers and amputations if not identified early. The Ipswich Touch Test was developed as a low-cost, efficient alternative to more complex tests like the 10g monofilament test. It requires no special equipment — only the examiner’s index finger — making it particularly useful in settings with limited resources or during routine primary care visits.
During the test, the examiner lightly touches the tips of the patient’s first, third, and fifth toes, as well as the dorsal surface of the big toe, on both feet. The patient closes their eyes and indicates when they feel each touch. If a patient fails to perceive two or more touches out of the total eight, it suggests a loss of protective sensation (LOPS), indicating clinically significant peripheral neuropathy. The key advantage of the Ipswich Touch Test lies in its ease of administration, minimal training requirements, and high inter-rater reliability, making it feasible for use by a wide range of healthcare providers.
Clinical studies have shown that the Ipswich Touch Test has a sensitivity comparable to the monofilament test for detecting neuropathy, while being even more accessible. Its adoption in clinical guidelines emphasizes the growing recognition of its value, especially in primary care and community settings where early detection of neuropathy is crucial to prevent downstream complications. While it doesn’t replace comprehensive neurological examination when warranted, it serves as a highly effective frontline screening tool for identifying patients who may require further assessment and management..
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