in this section we will discuss what is sensibility testing when we perform occupations in our uh daily life uh we need to be able to detect the um stimulation from the environment and we also need to differentiate that what kind of this uh stimuli um and how strong or the degree of the stimuli is you know to our body how do we interpret it and also U there's another sensation called uh sterio nosis it's how we uh recognize the object without looking at it so using sensibility testing we will need to use different kind of assessment tools for different kind of purposes and before we do that um we know that there there are are different typee of uh receptors um that help us to uh detect or receive the signal from the outside world there is mechano receptors there is chemo receptors there is um thermal receptors there are other receptors that help us to recognize is this harmful or this is safe um so so we so when we do this testing we need to understand uh the receptive field and the number of the sensory unit the receptive field is uh the area of the skin that serve by a single sensory input the center of the field actually is uh has the low uh threath hoold that means we can easily sense um the uh the input depending on how dense the area is if it's dense that means is highly sensitive that means we will have a larger uh representation area within the cortex so it's related in this way in the brain injury uh different types of sensation may be affected it can be light touch or prop perception we uh typically categorize them as the discriminatory sensation or it can be temperature or pain we categorize them as the protective sensation so in clinical practice uh when uh we uh do the evaluation and then we know uh the touch and prep perception is okay then typically uh the protective sensation like the temperature or the pain they are okay so evaluation on those two may be not necessary however if we know that this uh client doesn't have or impaired um temperature uh sensation or pain temp uh Sensation that means the discriminatory sensation is um damaged as well so this is some quick uh mindset that we do clinically so how do we do the sensation test or sensibility testing before we do that we need to prepare our client for the testing so first of all we need to be aware of the diagnosis of our clients and we want to ask we want to do a good history of uh what kind of injury or work what kind of um daily occupation or routines that they're doing so we understand the client better in a way um uh the the environment of testing is really important so we want to make sure that we reduce the distraction we can take them to a quiet room um the room temperature is okay and make sure that they're not too cold well not too warm and make sure that um they they feel comfortable relaxed and and before we perform the testing we want to make sure that they understand our directions so now uh when we move on to the next step of testing we want to make sure um that the body parts that we want to test is secure so secure doesn't mean that we immobilize those things but we want to make sure that we know that this is the area that we want to test right and when we do that make sure we do the uh testing twice one with the vision on the intch area so they can see what's going on they can feel what they're supposed to feel and then we can move to uh um um on testing on the same area but without the vision uh here so that they they know when they're not looking this this is uh the uh response that we are looking for be really careful when we say without Vision uh we want the vision to be occluded that being said that being blocked right do not ask your client to close the eyes or blindfold the eyes because other Sensation will be Amplified and this is not what we want to do because we want to make sure we test The Sensation that we are testing rather than the Amplified sensation so this is very key for sensation test and I want to repeat myself again so when we do the testing we uh first do it with Vision on the intch area and then we ask them to look away and then we test on the same area so U they understand what exactly is going to happen and by saying without Vision we mean Vision included we do not blindfold the eyes and we do not ask them to close the eyes because the Sensation will other Sensation will be Amplified okay so now doing the testing procedure make sure uh the stimulation that we apply is consistent we don't want to be like heart and light heart and light just confuse people we want to practice we have to practice so that every time we apply it's consistent however the interval of we applying the uh sensation testing can be like random because they um our client can guess or they can expect what's going to be next so and they will guess often times you know believe me they they guess right so to avoid this from happening we want to apply the stimula at in consistent intervals sometimes we kind of deceive them like did I touch you but actually we are not touching them right and make sure that U uh we apply the stimulation at the center of the zone so say if we want to do um a peripheral nervous system We Do It um by segment of um the fingers for example then we want to make sure that we apply the stimulation at the the center of the Zone uh make sure we document if um some of the client uh their skin condition is kind of um um special or uh different from other areas like uh callus or scar that would represent an you know abnormal response compared to other area of their skins um we definitely want to watch for those non-verbal cues to see if if you're confused or uh does this simulation kind of cause discomfort and make sure you document those kind of things um it's best that uh we document the protocol so that anything anyone um um not us if we have a different therapist to do it they know how to do it but of course the best way to do it is the same therapist always perform the same test to the same person if it's not we better document it so that someone other than us can do it the way that we did so we can compare the results afterwards speaking of comparing the results we want to make sure that everything we do is based on the evidence that being said we need to choose the instrument or assessment tools that's valid that's reliable that's been tested by research evidence to show uh it consistently show um that these are valid and reliable um um Tool uh for evaluating this thing and one other benefit of using standardized test is a lot of the test um tools they have built the norm um so for us to reference our result too so this is one of another benefit of um using the standardized um um instruments