Illustrates the popular methods of assessing sensations both superficial and deep sensations clinically along with appropriate illustrations and equipments used in assessing the sensation among clients(Adults)

1. Assessing sensations:
Vinodhini.C
Occupational Therapist

2. Sensation:
 Sensation (also called sensibility) is a body function, a component of the client
factors that influences both the motor and processing aspects of performance
skills.
 The somatosensory system handles sensory input from superficial sources such as
the skin and from deep sources such as the musculoskeletal system.

4. Superficial sensations:

5. Pain:
 Pain is an unpleasant sensory and perceptual experience that is associated with either actual
or potential cellular damage. The experience of pain is subjective and multidimensional.
 Test for Pain (Protective Sensation)
 Procedure
 Using a sterilized safety pin, assess the amount of pressure required to elicit a pain response
on the uninvolved hand. This is the amount of pressure that the examiner will use on the
involved side.
 Response
 The client indicates “sharp” or “dull” following application.
 Scoring
 A correct response to both sharp and dull indicates intact protective sensation.
 An incorrect response to both sharp and dull indicates absent protective sensation.

6. Pain:
Sharp pain Dull pain

7. Temperature awareness:
 Temperature awareness is a test for protective sensation. Thermal receptors detect warmth
and cold.
 Test for Temperature Awareness (Protective Sensation)
 Procedure
 Apply test tubes or metal cylinders filled with hot or cold fluid randomly to areas of the
involved hand
 Response
 The client indicates “hot” or “cold” following application.
 Scoring
 A correct response to both cold and hot indicates intact temperature awareness.
 An incorrect response to either or both indicates impaired temperature awareness.

8. Temperature awareness

9. Two-point discrimination:
 Two-point discrimination is a test for receptor density and is a good test to use for
mapping improvement following nerve repair.
 Types :
 Static two pd
 Moving two pd

10. Test for Static Two-Point Discrimination:
 Procedure
 Use a device such as the Disk-Criminator or Boley gauge with blunt testing ends
 Test only the fingertips because this is the primary area of the hand used for exploration
of objects.
 Begin with a distance of 5 ¯mm between the testing points.
 Randomly test one or two points on the radial and ulnar aspects of each finger for 10
applications
 Pressure is applied lightly; stop just when the skin begins to blanch.
 Response
 The client will respond “one” or “two” or “I don’t know” following application.

11.  Scoring
 The client responds accurately to 7 of 10 applications at that number of
of distance between the two points.
 Norms are as follows:
 1 to 5╯mm indicates normal static two-point discrimination.
 6 to 10╯mm indicates fair static two-point discrimination.
 1 to 15╯mm indicates poor static two-point discrimination.
 One point perceived indicates protective sensation only.
 No points perceived indicates an anesthetic area.

12. Two point discrimination:
Boley gauge Disk criminator

13. Touch pressure:
 Light touch is perceived by receptors in the superficial skin.
 Pressure (or deeper touch) is perceived by receptors in the subcutaneous and
deeper tissues.
 Procedure
 Begin with monofilament 1.65.
 Apply the monofilament for 1 to 1.5 seconds at the pressure needed to bow the
monofilament (applied perpendicularly)
 Hold the pressure for 1 to 1.5 seconds.
 Lift the monofilament in 1 to 1.5 seconds.
 The proper amount of pressure is achieved when the filament bends.

14.  Response
 The client says “touch” when he feels the monofilament.
 Scoring
 The client responds to at least one of the three applications of the monofilament.
 Norms are as follows:
 Green (1.65 to 2.83) indicates normal light touch.
 Blue (3.22 to 3.61) indicates diminished light touch.
 Purple (3.84 to 4.31) indicates diminished protective sensation.
 Red (4.56 to 6.65) indicates loss of protective sensation.
 Untestable indicates an inability to feel the largest monofilament.

15. Monofilament

16. Proprioception:
 Conscious proprioception derives from receptors found in muscles, tendons, and
joints and is defined as awareness of joint position in space.
 Test for Proprioception
 Procedure
 Hold the lateral aspect of the elbow, wrist, or digit.
 Move the body part into flexion or extension
 Response
 The client indicates whether the body part is being moved “up” or “down.”
 Scoring
 An accurate response indicates intact proprioception.

17. Testing proprioception of the finger.

18. Stereognosis
 Stereognosis is the use of both proprioceptive information and touch information
to identify an item with the vision occluded.
 The Dellon Modification of the Moberg Pickup Test
 Procedure
 Begin with a group of 12 standardized items: wing nut, large nut, hex nut, small
square nut, screw, key, nickel, dime, washer, safety pin, paper clip, and nail.
 With client’s vision occluded, the examiner places the items into the client’s radial
three digits one at a time.

19.  Response
 The client manipulates the objects and attempts to identify them as quickly as
possible.
 Scoring
 the time that it takes to identify all the items.

20. The Dellon Modification of the Moberg
Pickup Test

21. Thank you