Home Sensory Integration Program Protocol – Jason M., OT
There are more than enough supplies like books, hand outs, and flashcards available when setting up and educating a patient on a Home Exercise Program (HEP). The goals of these programs are always to improve the components of strength, balance, flexibility, range of motion, and endurance. What aren’t readily available are guidelines and/or protocols for an HEP to improve sensation. Whether the diagnosis is CVA, nerve damage, etc. a lack of sensation can be as limiting and debilitating as a lack in grip strength. As a solution I developed my own several years ago that has many times shown to be effective and easy to follow for patients, helping with compliance and outcomes. The following is the protocol that I developed that I share with you and your patients in hope that it provides a source or guide for a sensory HEP:
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Home sensory program is to be completed _____ x a day to improve sensation in affected area to maximize safe, efficient functional performance in daily activities.
1.) Massage
To be completed using techniques demonstrated by therapist.
2.) Vibration
Rub affected arm with vibrating end of massager in a variety of patterns (sideways, circles, etc.) Use light then heavy vibration speeds as tolerated.
3.) Bean Box
In plastic container large/long enough to hold entire affected area, fill with beans/rice two-thirds of the way full. Place in rice common house hold objects of various sizes (combs, pens, marbles, keys, etc.). Without looking and only using the affected hand, find ______ objects.
4.) Sensation Grading/Ramping
Collect at least 6 but no more than 10 fabrics of various textures, ranging from very soft and smooth (velvet, etc.) to more coarse and rough (rubber, leather, etc.)(but nothing abrasive such as sandpaper). Starting with the softest fabric, rub the affected area in various patterns over a period of _________ mins. Slowly increase the pressure applied. Then move onto the next roughest, repeat the process until using the roughest fabric. Then reverse the process until ending with the softest fabric again.
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As an addendum let me make particular notes on the protocol:
- Note that the patient doesn’t need to complete all the tasks for a successful HEP, since each item stimulates sensory receptors in different ways.
- For massage, consider teaching the patient techniques that do not require an extensive therapy background to effectively carry out.
- For vibration, the patient doesn’t necessarily need to purchase a massager, but educate the patient on manual tissue vibration and tapping techniques.
- For the bean box, understand that this is primarily for proprioception, but a certain amount for functional grip and range of motion will be needed to attempt.
I hope you can find a patient who can benefit from the protocol provided.
