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A Natural Part of Aging
It is often believed that sensory loss is a “natural part of aging.” As we age, our senses change. People often recognize that they are experiencing changes to senses like taste, vision, and hearing. They add a little more salt to their food, move the book a little closer, and turn the volume of the TV up a little louder. At some point, they either notice that they are making these changes to compensate or that the changes no longer provide the improved sensory input they need, and they seek medical attention. Patients often get glasses or hearing aids in order to manage the loss of vision or hearing, but many more complicated sensations are often left unrecognized and untreated.
Types of Sensation
Sensation is usually thought of as taste, smell, hearing, vision and touch, but those are not the only senses we utilize. The sense of touch itself is multifaceted, and it is perceived in a variety of ways. We sense texture, temperature, light pressure, deep pressure, and vibration all differently. Along with these senses of “touch,” we also have the sense of proprioception. Proprioception is the brain’s ability to recognize the body’s positioning in space. Proprioceptors exist throughout all the muscles and joints in the body. When you close your eyes and move your arm around, proprioception is what tells you where that arm is located. In 1826, proprioception was deemed the “sixth sense,” completely separating it from the concept of touch and establishing it as “the muscle sense.”
Sensation and Function
Our sensations have a complex job. The sensory system generates information, which is sent to our motor systems in order to generate movements and behaviors. We recognize that if we cannot sense pain, we do not know to move our hand away from a hot pan. The actual neurological process is extensive; however, basic principles can be understood by everyone. The sensory nervous system collects stimuli through our senses and reports them back to our brains. Our brains then take that information from both the outside world and inside our bodies and determine appropriate reactions. Without sensory input, our bodies have no interaction with the world around us or within us.
How Sensation Impacts Rehabilitation
Major sensory changes can occur with conditions such as stroke, Parkinson’s disease, or traumatic brain injury, but also as a general part of aging. Sensory deficits impact a person’s ability to enjoy and explore the world around them. Just like you cannot expect a customer to be able to read a menu they cannot see; we cannot expect patients to properly utilize muscles they cannot feel.
As an Occupational Therapist, I often hear the following complaints: “Sometimes my hands/feet just don’t feel like they are mine anymore,” “I made great progress when I was in therapy, but a few months later I was back to what I was doing before,” or “if I don’t look at my feet how am I supposed to know what I am doing.” These are all signs of sensory changes that often go unnoticed or untreated.
When it comes to rehabilitation, there tends to be a stronger focus on restoring movement versus sensation. The deep connection between the two is often overlooked. In reality, the body’s processes are a two-way street of motor and sensation. Sensory input informs our motor output.
For example, let’s take the case of an 82-year-old man. He is highly active in his community but has poor posture, so he slowly starts using a cane. His doctor sees that he is now using a cane and refers him to therapy. Over a 5 year period, he goes to therapy and corrects his posture 5 times. It is common knowledge to his doctors and therapists that he cannot feel below his knees, and yet they never directly address that issue. Each time this patient works his way off of his cane, he is able to perform for about 3 months before he slowly works his way back. What is happening here?
The gentleman in question cannot feel his feet. If you cannot feel your feet, instinctively, your body is going to attempt to get the sensory input another way; for example, by looking at your feet. When he looks at his feet, he is hunching over, causing muscular decline, which eventually throws off his balance and all of the progress he has made.
Sensory Retraining as a Vital Part of Rehabilitation
Sensory changes can be a normal part of the aging process, but that does not mean that they cannot be corrected or improved. Sensory retraining as a precursor to motor skills training leads to improved results. With improved sensation, patients are able to further isolate weak or damaged muscles, correct positioning, and maintain muscular results for longer periods of time. When a therapist successfully corrects a patient’s posture but doesn’t restore or correct the behavior that caused the decline, it is only a matter of time before the patient returns to their prior level of function.
MOBILE REHAB—CONCIERGE OUTPATIENT THERAPY
Concierge Outpatient Therapy allows patients to receive a higher level of personalized care within the comfort of their own homes and communities. Chronic patients need high quality therapy with the ability to work outside of home health and outpatient restrictions.
Mobile Rehab is not a home health provider. Mobile Rehab is a Medicare Part B Approved Provider for therapy services outside of home health restrictions. Like a traditional Outpatient Therapy Facility, but our therapist travel to the patient’s homes and communities. This removes the burden of travel, decreases risk for infection, and increases patient compliance. Therapists are able to asses real conditions, design programs that can be utilized for an extended period of time, and provide more personalized care.
We believe that our clients are long term members of the Mobile Rehab Family and we care about their long term success
CALL TODAY TO SCHEDULE YOUR APPOINTMENT OR ASK YOUR MEDICAL PROVIDER FOR A REFERRAL.
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