Sensory Examination in Physical Therapy

Sensory Examination

• Sensory integration is the brain's ability to organize, interpret, and use sensory information.
• Sensory function examination involves testing sensory integrity by determining the patient's ability to interpret and discriminate among incoming sensory information.
• Sensory integrity is defined as the intactness of cortical sensory processing, including proprioception, pallesthesia, stereognosis, and topognosis.

Clinical Indications

• Indications for examining sensory function are based on the history and systems review.
• This includes information provided by the patient, family, significant other, or caregiver, symptoms described by the patient, signs observed during the systems review, and information derived from other sources and records.
• Sensory dysfunction may be associated with pathology or injury affecting the peripheral nervous system (PNS) or central nervous system (CNS), or with combined involvement of both systems.

Factors That May Constrain The Examination

• Arousal level should be determined prior to the sensory examination.
• Arousal is the physiological readiness of the human system for activity.
• Arousal levels include:
  • Alert: awake and attentive to normal levels of stimulation, with normal interactions with the therapist.
  • Lethargic: drowsy, may fall asleep if not stimulated, with diverted interactions with the therapist.
  • Obtunded: difficult to arouse from a somnolent state, frequently confused when awake, with unproductive interactions with the therapist.
  • Stupor (semicoma): responds only to strong, noxious stimuli and returns to unconscious state when stimulation is stopped, with inability to interact with the therapist.
  • Coma (deep coma): cannot be aroused by any type of stimulation.