SENSe Discrimination training: a clinical training package
A clinical training package and protocol have been developed to support the application of SENSe Therapy. SENSe therapy is recommended in the National Stroke Guidelines and best-practice recommendations.
The SENSe training approach builds on the ability of the brain to adapt and learn new skills. It has been designed to assist stroke survivors to improve functional sensation and generalise these skills to novel stimuli that have not been trained, as well as to everyday functional tasks. For example, a client with impaired touch sensation will be trained to discriminate differences in textures that vary in surface characteristics and to transfer this skill to discriminating differenced in novel textures. SENSe training directly targets improvement in somatosensory capacities so that these improved skills can be used more effectively in a wide range of contexts and activities.
- Improvement in the ability to discriminate common textures through the sense of touch,
- Knowledge of where one’s arm is in space, and
- More optimal exploration, recognition and use of common objects using the sense of touch, rather than having to rely on vision or other compensation approaches.
Who can conduct SENSe training?
SENSe therapy has been successfully conducted by occupational therapists and physiotherapists. Therapists need to be specifically trained in the SENSe approach.
Who is SENSe training most appropriate for?
SENSe therapy is suitable for persons who have impaired ability to discriminate body sensations following stroke, particularly those with impaired texture discrimination, limb position sense and recognition of objects through touch. Impairment in body sensations after stroke may be identified using formal sensory assessments and observation in occupational tasks.
Can SENSe be used with patients who have little/no movement?
Yes: however, it is important for the person with little/ no active movement can attend to, sense and involve their affected limb where possible. The client can get access to the sensory stimuli to be discriminated in training through guided movement by the therapist. For examples of how to facilitate these guided movements please refer to our SENSe Training Manual.
What are the 7 principles of SENSe training?
- Select – specially designed training tasks, with opportunity for grading and transfer
- Attentive exploration – goal-directed, give response
- Feedback – on critical features of sensation and exploratory procedures, immediate and precise
- Calibrate – match altered sensation with more normal sensation experienced through the other hand and vision
- Anticipate – deliberate use of anticipation trials where the client knows what to expect o feel, choices are reduced to highlight distinctive differences
- Repeat and progress – repetition and progress to more difficult discriminations and tasks
- Transfer – matrix of stimuli and training conditions to facilitate skills transfer and transfer to untrained activities.
Timeframes/ frequency of treatment
SENSe has been shown to be effective when training is provided at a rate of 3 times a week for 10 sessions. Each session is about 60 minutes and includes training of 2 or 3 sensory attributes and/or occupational tasks.
Clinician Perspectives on SENSe
“Very interesting and rewarding therapy”
“Wonderful to see clients learn how to retrain their sense of touch and use their hand more meaningfully in their daily life”
Reading: Carey, L.M., Macdonell, R. & Matyas, T. (2011). SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation. A randomized controlled trial. Neurorehabilitation and Neural Repair, 25, 304-313. Link to paper.
For more information on SENSe Therapy, the SENSe training principles and the evidence supporting SENSe therapy and its application, please visit:
This section includes evidence from:
- SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation. A randomized controlled trial (link to Carey et al., 2011)
- Training of somatosensory discrimination after stroke: Facilitation of stimulus generalization (link to Carey & Matyas, 2005)
- Sensory loss in stroke patients: effective training of tactile and proprioceptive discrimination (link to Carey et al., 1993)
- Change in functional arm use is associated with somatosensory skills after sensory retraining poststroke (link to Turville et al., 2017)
- Initial severity of somatosensory impairment influences response to upper limb sensory retraining post-stroke (link to Turville et al., 2018)
Carey, L.M., Macdonell, R. & Matyas, T. (2011). SENSe: Study of the Effectiveness of Neurorehabilitation on Sensation. A randomized controlled trial. Neurorehabilitation and Neural Repair, 25, 304-313.
Carey, L.M., & Matyas, T.A. (2005). Training of somatosensory discrimination after stroke: Facilitation of stimulus generalization. American Journal of Physical Medicine and Rehabilitation, 84(6), 428-442.
Carey, L. M., Matyas, T. A., & Oke, L. E. (1993). Sensory loss in stroke patients: effective training of tactile and proprioceptive discrimination. Archives of Physical Medicine and Rehabilitation, 74(6), 602-611.
Carey, L.M. (2006). Loss of somatic sensation. In M. Selzer, S. Clarke, L. Cohen, P. Duncan, & F. H. Gage (Eds.), Textbook of Neural Repair and Rehabilitation (Vol II. Medical Rehabilitation, pp. 231-247). Cambridge, United Kingdom: Cambridge University Press.
Turville, M. Carey, L.M., Matyas, T.A. & Blennerhassett, J. (2017). Change in functional arm use is associated with somatosensory skills after sensory retraining poststroke. The American Journal of Occupational Therapy, 71(3), 1-9.
Turville, M., Matyas, T., Blennerhassett, J. M., & Carey, L. M. (2018). Initial severity of somatosensory impairment influences response to upper limb sensory retraining post-stroke. NeuroRehabilitation, 43(4), 413-423.