Sensory rehabilitation

[JanetThomas]

I would like to know if anybody regularly includes sensory retraining after stroke during physiotherapy? Do we just leave our patients with a useless hand because they cannot feel it. Does anybody have any comments on this

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[reeces]

If the client has no active movement in his arm (not even minimal or flickers), no sensation/proprioception, but he can already move his leg and trunk (and he is functional i.e. can walk anywhere unaided, use toilet, sit unsupported and do any activity with his good arm etc etc etc)....surely sensory rehabilitation is really pointless - however it is essential to teach him to maintain range of movement, swelling, awareness, etc (so he doesnt injure it). But of course it will depend on the individual and the extent of the stroke.
I find that clients with localised lesions (i.e. head injuries due to gun shot wounds, knife stabs or localised bleeding) generally get better results than those with strokes. I also have this rule of thumb (but its not always true) - during recovery from a CNS lesion, movement returns from head to toe - meaning if a client moves his leg but cannot move his arm at all then it is unlikely that he will move his arm again.