You can then decide whether to initiate sensory re-education or instruct the patient in compensatory techniques. When taking the history, note the physical appearance of the hands, including skin condition, nails, symmetry, scars, open wounds and color. A patient who has small cuts on his hands may be cutting himself while performing ADLs and not even realizing it. Assess motor function and strength and obtain a description of how the patient's hands feel. When performing sensibility evaluations, you can choose simple or more detailed tests.
Most clinicians rely on simple tests, since time constraints usually prohibit more extensive exams.
First, map out the area of dysfunction. Threshold tests assess pain, heat, cold, touch and vibration. These exams help clinicians monitor sensibility during early months of dysfunction and determine the minimum stimulus a patient perceives. For example, the pinprick perception shows a patient's ability to perceive painful or potentially harmful stimuli. Pricking with a simple safety pin can assess a patient's ability to differentiate between sharp and dull stimuli.