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Introduction
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Principles and rules of somatosensory examination

Minimizing extraneous cues

It is important for the health care practitioner to minimize external cues in order to attribute performance to the specific sensory modality being tested rather than the patient’s ability to interpret extraneous cues. The first step is to eliminate vision as a cue. The typical process for administering a test or measure for a specific sensory modality is as follows:
  • Explain the procedure with the patient’s eyes open.
  • Demonstrate the procedure and ask for the patient to respond with his/her eyes open.
  • Repeat the demonstration to ensure that the patient understands the procedure.
  • Perform the test or measure with the patient’s eyes closed or vision occluded (i.e., as applicable for a specific test or measure).
  • Monitor the patient to make sure that vision is not being used to assist with responses.
Eliminate extraneous tactile cues
The second consideration is to eliminate extraneous tactile cues. This is done by using precise manual contacts and making certain that clothing or other articles do not touch the patient in addition to the stimulus. Manual contacts should provide minimal clues as to the stimulus being provided. For example, when testing joint position sense and joint movement sense, manual contacts should be confined to the lateral aspect of the limb segment, as contact on the ventral or dorsal surfaces can give pressure clues for movement. Furthermore, the limb segment being tested should not touch any surfaces or receive information from external objects while moving (i.e., clothing).



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Section: Introduction
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