Background

Sensation is how our body processes internal and external stimuli. Stimuli can come from within our body, such as the vestibular and interoceptive senses, and it also comes from the environment, such as when we smell or hear something. In this section, we cover techniques that the occupational therapist (OT) can use to screen, assess, and intervene for a client with sensory deficits. We will primarily focus on different touch and proprioceptive assessments and interventions.

In Occupational Therapy Assistant (OTA) 1180, we discussed the sensory integration model and how to apply it for sensation deficits. Sensation dysfunction occurs if the brain does not properly organize and integrate information. In OTA 1140, we learned that interventions for sensation can take on a remedial or compensatory approach. For example, in OTA 1130, we used goggles to mimic vision impairments, which forced us to rely on our other senses such as hearing and tactile cues. A similar principle is applied to compensatory intervention. If our client has a protective sensation loss, we teach them to scan their environment for safety hazards.

Defining Sensation

This video explains the distinction between sensation and perception and how our brain registers perception of sensation and adapts to enable us to engage in occupation.

Video is licensed under CC BY 4.0.

Defining Sensation Video Transcript

Sensation Stimuli Tips

• Registration vs. Perception
  • Registration is determining whether your brain can recognize a sensation.
  • Perception is making sense of the sensation.
• Sensory Threshold
  • A sensory threshold is the level of stimulation that we need to detect a sensation. Our body adjusts our sensory threshold throughout the day. For example, when you first walk into someone’s home, you will notice the house’s smell. After about twenty minutes, you will not notice the smell anymore.

Sensation Assessment

This video explains different sensation assessments. These techniques include light touch, sharp versus dull, temperature, Semmes Weinstein Monofilament test, two-point discrimination tool test, proprioception, and stereognosis.

Sensation Assessment Video Transcript

Sensation Assessments Tips

• Sensation assessments are used to determine what sensory deficit a person may have.
• The following are steps for assessing light touch, sharp versus dull, temperature, Semmes Weinstein Monofilament test, and two-point discrimination tool test:
  • Explain the purpose of the assessment.
  • Demonstrate the technique on yourself.
  • Demonstrate on your client’s unaffected side with their eyes open.
  • Assess your client’s sensation by completing five trials on their affected side with their eyes closed.

Sensation Intervention

This video explains different interventions that the OT can use to address their client’s sensation deficits, including hypersensitivity and hyposensitivity.

Sensation Intervention Video Transcript

Sensation Intervention Tips

• Hyposensitivity: The client’s threshold is high—it is hard for the brain to detect stimuli. Pick tasks where sensory stimuli will be just above the threshold and barely detectable.
• Hypersensitivity: The client’s threshold is low—it is easy for the brain to detect stimuli. This can be negative because even low-level stimuli can become uncomfortable for them. Pick a task that is tolerable but uncomfortable.

Resources

• Complex Regional Pain Syndrome (CRPS) Treatment: Desensitization by Melanie E. Swan, OTR/L
• Sensory Training: Translating Research to Clinical Practice & Home Program by Nel Ledesma, MHS, OTR/L, presented to Michigan Occupational Therapy Association on October 10, 2019.