SENSORY ASSESSMENT
DR VAISHALI JAGTAP
SENSORY ASSESSMENT
• Sensory impairments interfere with acquisition of
new motor skills since motor learning is dependent
on sensory information and feedback
• SENSORY ASSESSMENT PRINCIPLES:
• Sensory assessment is completed prior to any testing
that involves active motor function
• Initial screening for mental status (arousal, attention,
orientation, cognition & memory), vision & memory
should be done prior to performing sensory tests.
• Patient should be instructed not to guess if
uncertain about the response
• Demonstrate the test to orient the patient on
what to expect and what response is needed
• Test order:
• Superficial—Deep—Cortical… & Distal to Proximal
• Apply the stimuli in a random order to avoid
giving patient “clues” to the correct response
• It is good to use a chart or picture to represent
the areas with sensory problem so as to easily
identify if a certain pattern exists
SENSORY EXAMINATION
SUPERFICIAL COMBINED CORTICAL
DEEP SENSATIONS
SENSATIONS (EXTEROCEPTORS+PROPRIOCEPTOR
(PROPRIOCEPTORS -from
(EXTEROCEPTORS- S+INTACT FUNCTIONS OF CORTICAL
lig ,jts, muscles, tendons,
from skin and SENSORY ASSOCIATION AREAS)
fascia)
subcutaneous
tissues) -STEREOGNOSIS
-PROPRICEPTION
-PAIN -2 POINT DYSCRIMATION
-KINESTHESIA
--TEMPERATURE -BAROGNOSIS
-VIBRATION
--LIGHT TOUCH -GRAPHESTHESIA
--PRESSURE -TACTILE LOCALIZATION
-RECOGNITION OF TEXTURE
DOUBLE SIMULTANEOUS
STIMULATION
EXAMINATION
Superficial sensation
• Pain
Use sharp end of a pin,
Avoid applying stimuli close to each other
Let finger slide over the pin
• Light touch
Use cotton or camel hair Brush
• Pressure
Use thumb enough to indent skin
• Temperature Use test tubes with warm (41-50˚F) and cold (104-113˚F)
• Response-When patient feels stimuli, respond with yes, no or unable to tell
Deep sensation
• Kinesthesia
Move the extremity passively in initial, mid or
terminal range with very minimal grip to Reduce
tactile stimulation
Response Describe direction as up or down, in or
out while the extremity is in motion. Also patient
can imitate the movement in opposite extremity.
• Proprioception
The extremity is held in a static position in
initial, mid or terminal range with very
minimal grip to reduce tactile stimulation
Response- Describe direction as up or down, in
or out while the extremity is in static position.
Also patient can imitate the movement in
opposite extremity.
• Vibration
Place the base of a vibrating tuning
fork on a bony prominence. Random
application of vibrating and non
vibrating stimuli should be done.
Patient should also be given earphones
to remove the auditory clues.
• Response -Verbally identify the
vibrating stimuli
Combined Cortical sensation
• Stereognosis
The patient is given a familiar
object to be held and
manipulated
Response The patient is asked
to identify the object verbally
• Tactile localization
Therapist touches different areas in patient
skin surface
Response -Patient points out the area that the
therapist touches
• Two-point Discrimination-
Apply simultaneous stimuli on the
patient’s skin
Response Identify if the perception of
one or two stimuli
• Graphesthesia –(traced figure
identification)
Trace letters, numbers or designs on
skin
Response- Identify what is the traced
figure
• Barognosis (recognition of wt)
small objects with same size & shape but different
weights are used.
Response –heavy/ light than other object
(compares wt of one object with other)
• Recognition of texture
cotton, wool, silk material/cloth
Response- silk/cotton, smooth/rough
• Double simultaneous stimulation-
it’s the ability to perceive simultaneous touch
stimulus (prox & distally on single extremity or
prox & distally on one side of body)
Response –
verbally states if he perceives the stimuli and
number of stimuli felt
