Sensory Re-education

Sensation may be impaired after stroke. Numbness, tingling, hypersensitivity, and varying degrees of sensory loss can occur. Sensory re-education is a technique therapists use in attempt to retrain sensory pathways or stimulate unused pathways. Therapists also teach adaptive techniques to help compensate for sensory loss. Sensory re-education techniques can include touching different textured objects, massage, vibration, pressure, determining joint position, identifying different temperatures, and electrical stimulation.

Listed below are some exercises to help with sensation. For maximum improvement, perform exercises 2-4x day for 10 minutes in a quiet room.

Sensory Re-education Exercises

Try to differentiate between textures (i.e. cotton, sandpaper, satin, velcro, rubber, velvet, wool, etc.)

Hide objects such as marbles, coins, etc. in a bowl of rice/dry beans/sand. Without using vision, try to find the objects with your hand.

Have another person touch you on one spot with your eyes open, then with your eyes closed. Try to associate where you saw object touch your skin to how it felt on your skin.

Have another person keep pressure still on your skin then move it around. Watch and pay attention how it feels. Close eyes and try to identify when the pressure is still versus when it is moving.

Close your eyes and have a person apply vibration to your skin via a massager. See if you can identify when the vibration is applied to the skin. Have the person move the vibration around and see if you can tell when it is still versus moving around on your skin.

Have someone place different objects in your hand while you are looking (i.e. cotton ball, marble, key, paper clip). Close your eyes and then try to identify objects as they are placed in your hand again one at a time.

Fill a flexible paper cup (i.e. Dixie cup) half full with water. Attempt to grasp cup without spilling the water or smashing the cup. Use your vision to determine how much pressure you are putting on the cup (i.e. if cup is slipping out of hand, apply more pressure; if cup is squeezed to hard, lessen grip)

Repeat exercise with paper cup above but now move the cup from one spot to another maintaining a steady, even grasp (not too tight, not too loose)

Have another person apply cold and or warmth to your skin and see if you can detect temperature differences.

Feel an object then try to find a matching object inside bowl of dry beans or rice.

Close eyes and have someone else position your affected arm. See if you can tell what position your arm is in (i.e. my elbow is bent) then open your eyes to see what position it is in.

Close eyes. Have someone else place a lighter object on your hand then a heavier object. Try to determine which object was heavier or lighter.

Block your vision or close eyes. Have someone else move your hand while holding a pencil. Try to identify what letter, number or drawing is made.

Adaptive or Compensatory Techniques

Use your vision to observe motion and location of body parts.

Use your unaffected side to check temperature before bathing or washing objects.

Use your unaffected side to handle sharp objects.

Use built up handles on the affected side to distribute pressure (the smaller the handle the less distribution of pressure over the gripping surfaces).

Change positions frequently to prevent too much pressure on affected area.

Sit on cushion to protect skin.

When gripping an object, don't apply more force than is necessary.

Observe the skin for swelling, redness, warmth

Take care of skin.

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