SENSORY ASSESSMENT.pdf
- 1. SENSORY ASSESSMENT Suvarna Ganvir DVVPF’s College of Physiotherapy, Ahmednagar 1 10/8/2022
- 2. Objectives At the end of lecture the learner shall be able to 1. Classify sensations 2. Describe preparation of patient 3. Describe assessment of sensations 2 10/8/2022
- 3. Classification of sensations Sensations Superficial Deep Combined cortical 3 10/8/2022
- 5. Deep Kinesthesia Proprioception Vibration 5 10/8/2022
- 6. Combined cortical Stereognosis Tactile localisation Two point discrimination Double simultaneous stimulation Graphesthesia Recognition of texture Barognosis 6 10/8/2022
- 7. Patient Preparation Comfortable relaxed position Full explanation or purpose of the test Informed about the cooperation required Requested ‘not to guess’ Occlusion of vision 7 10/8/2022
- 8. A trial run or demonstration of each test should be performed This will orient the patient to the sensation being tested Trial run is a must for patient understanding without which the result of test may get affected. In case of verbal affection, ask patient to raise his hand or fingers when he feels the sensation 8 10/8/2022
- 9. ❑ SUPERFICIAL- TOUCH PAIN TEMPERATURE PRESSURE 9 10/8/2022
- 10. Touch Sensation Perception of a tactile touch input Equipment : A camel hair brush, Cotton or tissue is used Stimulus: area to be tested is lightly touched or stroked, Response: patient should indicate when he recognizes a stimulus by responding ‘Yes or no’ 10 10/8/2022
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- 12. Temperature Awareness Ability to distinguish between warm and cool stimuli. Two test tubes with stoppers One filled with warm water – 40-45 degrees (104-113 farenheit) Other filled with cold water – 5-10 degrees (41-50 degree farenheit) More temp- pain sensation 13 10/8/2022
- 13. Side of the test tube – contact with skin Provides sufficient surface area contact Test tubes are randomly placed in contact with skin All skin surfaces should be checked. 14 10/8/2022
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- 15. Pain perception Sharp/Dull discrimination Indicates function of protective sensation Sharp and dull end of a large headed or safety pin Randomly applied perpendicular to the skin Stimuli should not be applied too close or in too rapid succession Response- Verbally indicate – Sharp or dull 16 10/8/2022
- 16. Pressure Therapist’s finger tip or a double tipped cotton swab Firm pressure on the skin Firm enough to indent the skin Achilis tendon squeezing Response- indicate yes or no 17 10/8/2022
- 17. ❑ DEEP- JOINT POSITION KINESTHESIA AWARENESS VIBRATION 18 10/8/2022
- 18. Kinesthetic awareness Awareness of movement Extremity or joint is moved through a small ROM- Initial , mid range or end range Therapist grip should not give tactile stimulation Trial session Response- describe verbally the direction and range of movement while the extremity is in motion May respond by duplicating the movement on other side 1919 10/8/2022
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- 20. Proprioceptive awareness Joint position sense or awareness of joints at rest Extremity or joints is moved through a ROM and held in a static position Small increments of ROM are used Hand placement should be such that it causes minimum tactile stimulation 21 10/8/2022
- 21. Response- while the extremity or joint is held in a static position , patient is asked to describe the position verbally or to duplicate the position of the extremity with contralateral extremity 22 10/8/2022
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- 23. Vibration perception This test requires a tuning fork of 128 Hz Ability to perceive a vibratory stimulus Tines are briskly hit against the open palm of the examiner Base of a vibrating fork is placed on a bony prominence before and after hitting the tines Random application of vibratinng and non vibrating stimuli 24 10/8/2022
- 24. Response– Patient is asked to respond verbally identifying or otherwise indicating , if the stimulus is vibrating or non vibrating each time fork makes contact. 25 10/8/2022
- 25. ❑ CORTICAL- TACTILE LOCALISATION TWO POINT DISCRIMINATION STEREOGNOSIS BAROGNOSIS GRAPHESTHESIA RECOGNITION OF TEXTURE 26 10/8/2022
- 26. If superficial touch sensations is absent over a specific area, it is not possible to check some cortical sensations in that area. Due care should be taken while interpreting the results. 10/8/2022 27
- 27. Tactile Localisation Ability to localise touch sensation on the skin Ability to identify the specific point of application of touch stimulus. Using a cotton swap or fingertip, the therapist touches different skin surfaces. After each application of a stimulus the patient is given time to respond. 28 10/8/2022
- 28. Response: The patient is asked to identify the location of the stimuli by pointing to the area or by verbal description 29 10/8/2022
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- 30. Two point discrimination Ability to perceive two points applied to the skin simultaneously. It is a measure of the smallest distance between two stimuli (applied simultaneously and with equal pressure) that can still be perceived as two distinct stimuli. Aesthesiometer and two point discriminator is used Two reshaped paper clips can also be used, but needs another examiner to assist 31 10/8/2022
- 31. With each successive application, the two tips are gradually brought together until the stimuli are perceived as one. The smallest distance between the stimuli that is still perceived as two distinct points is measured. Response : The patient is asked to identify the perception of 'one' or 'two' stimuli. . 32 10/8/2022
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- 33. Stereognosis Tactile object recognition Small easily obtainable, and culturally familiar objects of differing sizes and shapes(e.g. Key , combs, safety pins, pencils), Patient is blind folded and therapist give a object to the patient's hand. Patient should be allowed to handle several sample test items during the explanation and demonstration Patient has to identify the object with the eyes closed. 34 10/8/2022
- 34. Response : Patient is asked to name the object verbally. In case of speech impairments , patient can point at the picture of an object (sensory testing shields) 35 10/8/2022
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- 36. Graphesthesia (traced figure identification) Ability to recognise letters numbers or designs A series of letters, numbers, or designs is traced on the palm of the patient's hand. Between each separate drawing the palm should be gently wiped with a soft cloth to clearly indicate a change in figures to the patient. The test is also useful substitute for stereognosis when paralysis prevents grasping an object. 37 10/8/2022
- 37. Response : The patient is asked to identify verbally the figures drawn on the skin. Patients with speech impairments may point at the drawing of the stimulus. 38 10/8/2022
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- 39. Recognition of texture Suitable textures may include cotton,wool,or silk. The items are placed individually in the patient's hand. The patient is allowed to manipulate the sample texture. Patient is asked to identify the individual textures as they are placed in the hand.may be by name or by texture. 40 10/8/2022
- 40. Barognosis A set of discrimination weights consisting of small objects of the same size and shape but of graduated weight is used. The therapist may choose to place a series of different weights in the same hand one at a time, place a different weight in each hand simultaneously, or ask the patient to use a fingertip grip to pick up each weight. The patient is asked to compare the weight. 41 10/8/2022
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- 45. Commonly asked questions Assessment of cortical or superficial and deep sensations 7M Give classification of sensations 3M 46 10/8/2022
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