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Nsainstructionsrevised

The document provides instructions for assessing sensory function in patients through tests of tactile sensation, kinaesthetic sensation, and stereognosis. Key steps include testing areas of the body for light touch, pressure, temperature and pinprick while blindfolded. Movement and joint position sense are evaluated by having the patient mirror examiner movements. Stereognosis is assessed by having the patient identify common objects by touch alone. Scoring criteria from 0 to 3 are provided to evaluate performance on each test.

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Sofia Ferreira
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52 views2 pages

Nsainstructionsrevised

The document provides instructions for assessing sensory function in patients through tests of tactile sensation, kinaesthetic sensation, and stereognosis. Key steps include testing areas of the body for light touch, pressure, temperature and pinprick while blindfolded. Movement and joint position sense are evaluated by having the patient mirror examiner movements. Stereognosis is assessed by having the patient identify common objects by touch alone. Scoring criteria from 0 to 3 are provided to evaluate performance on each test.

Uploaded by

Sofia Ferreira
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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NOTTINGHAM SENSORY ASSESSMENT

Instructions

The patient should be assessed in sitting and in a suitable state of undress (ideally in shorts &
underwear, without TED stockings). It should be ensured the patient is comfortable and in a quiet area
with no distractions. Each test is described and demonstrated to the patient before he or she is
blindfolded. The blindfold is removed regularly throughout the test to avoid the patient becoming
disorientated.

The body area to be tested is as marked on the body chart. Apply the test sensation
to the test area, to the left and right side in a random order. The patient is asked to
indicate, either verbally or by a body movement, whenever he or she feels the test
sensation.

Each part of the body is assessed three times for each of the tests.

Presence of a reflex does not count as awareness of sensation, though this should be
commented on in the comment box.

Tactile Sensation

If the patient has problems communicating begin testing light touch, pressure and
pinprick sections.

Scoring criteria

0 Absent Fails to identify the test sensation on three occasions


1 Impaired Identifies the test sensation, but not on all three occasions in each region
of the body or feels duller
2 Normal Correctly identifies the test sensation on all three occasions 9 Unable to
test

Light Touch Touch, not brush, the skin lightly with a cotton wool ball.

Pressure Press the skin just enough to deform the skin contour using the index finger.

Pinprick Prick the skin with a neurotip, maintaining even pressure.

Temperature Touch the skin with the side of one of two test tubes, one filled with hot water, one filled
with cold water (use the sides, not the bases of the test tubes). Apply hot and cold tubes
in random order.

Tactile localisation Only test those areas on which the patient has scored 2 on the pressure section.
Record all others as 9.
Repeat the pressure test with the index fingertip coated with talcum powder to mark the
spot touched and ask the patient to point to the exact spot that has been touched. If
communication permits, the test may be combined with the pressure test. 2cm of error
are allowed.

Bilateral Touch corresponding sites on one or both sides of the body using the fingertips and
Simultaneous ask the patient to indicate if both or one (and which) have been touched. Only test
Touch those items on which patient has scored 2 on pressure section. Record all others as 9.
Equipment required: Blindfold, cotton wool ball, Neurotip, two test tubes, hot and cold water, talcum
powder.
Kinaesthetic Sensations
All three aspects of movement are tested: appreciation of movement, its direction and accurate joint
position sense are assessed simultaneously. The limb on the affected side of the body is supported and
moved by the examiner in various directions but movement is only at one joint at a time. The patient is
asked to mirror the change of movement with the other limb. Three practice movements are allowed
before blindfolding.

The upper limb is tested in sitting, and the lower lying supine.

Scoring
0 Absent No appreciation of movement taking place.

1 Appreciation Patient indicates on each movement that a movement takes place but the of
movement direction is incorrect.
taking place

2 Direction of Patient is able to appreciate and mirror the direction of the test movement
movement taking place each time, but is inaccurate in its new position.
sense

3 Joint Position Accurately mirrors the test movement to within 10°of the new test position sense

9 Unable to test

Equipment required: Blindfold.

Stereognosis
The object is placed in the patient's hand for a maximum of 30 seconds. Identification is by naming,
description or by pair-matching with an identical set. Affected side of the body is tested first. The object
may be moved around the affected hand by the examiner.

Scoring for each object


2 Normal Item is correctly named or matched.

1 Impaired Some features of object identified or attempts at descriptions of objects.


0 Absent Unable to identify the object in any manner.

9 Unable to test

Equipment required: Blindfold, 2p coin, 10p coin, 50p coin, biro (score 2 if labelled "pen"), pencil,
comb, scissors, sponge, flannel (score 2 if labelled "cloth" or "face cloth"), cup, glass (score 2 if labelled
"beaker").

© University of Nottingham 2007

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