FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Graded Sensory Input for Reduced or Altered Sensation

Most likely fit: Contact feels faint, absent or unfamiliar, and a safe, tolerable input can be paired with a simple task. [Clinical consensus; the particular practice sequence is an educational adaptation, not a tested standalone treatment]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For the Person With FND

What this approach is for

This approach offers ordinary, predictable contact while you look at or use the affected area. The starting point might be resting a hand on a smooth cloth. Stronger sensation is not automatically more useful, and no sensation at all is not a reason to increase force.

A treatment goal could be keeping a hand comfortably on the table during a meal. It need not be “feel everything normally.” If touch is painful, use the separate desensitization page and obtain assessment of the pain.

Terms in everyday language

Sensation is your experience of information from the body. Skin receptors and nerves carry information about contact. The spinal cord and brain help process it. Hypoaesthesia means reduced sensation; paraesthesia means an unusual sensation such as tingling. These words describe what is experienced, not its cause.

A practical example and flare adaptations

Choose a stable seated position and a room-temperature, non-abrasive material. Look at the contact and describe something about the material or task. Lift and replace the hand if comfortable, then finish with an ordinary action such as folding the cloth.

Use a short trial chosen with the therapist. Stop if pain grows, the skin changes or the activity leaves you worse for a prolonged period. Do not rub harder, use ice or heat, or introduce needles to make the area respond. During a familiar flare, protecting the area may be all that is useful.

These are choices to discuss with your care team, not a required exercise schedule. Helpful activity, comfort and access matter even when sensation remains altered. The evidence and its limits are explained below. (Sources: 1, 2, 3)

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Family, Friends, and Other Supporters

Offer two comfortable materials and let the person choose. Tell them where contact will occur and wait for permission. A neutral answer such as “I cannot feel it” is valid; there is no need to repeat the test until a different answer appears.

If the person cannot manage practice during a flare, remove hazards and help with the interrupted activity. Avoid describing a sensory response as proof that the person could have felt it earlier.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Clinicians and the Care Team

Selection and assessment

Differentiate reduced detection from pain, dysaesthesia and impaired position sense. Review the diagnostic formulation and relevant peripheral nerve, root and central findings. Assess skin integrity and protective sensation before selecting any stimulus. A non-anatomical distribution alone is insufficient justification to stop investigating a changed presentation.

Explicit procedure

  1. Choose one contact-dependent activity and document the person’s description of the affected area.
  2. Inspect the site and establish a safe baseline position and input; avoid temperature challenges and sharp stimuli.
  3. Demonstrate contact visually, then allow self-application or agreed therapist contact.
  4. Pair the input with one low-demand action rather than a prolonged detection examination.
  5. Ask about tolerability after the trial and check the skin.
  6. Change only duration, contact area or task demand at the next trial; do not increase intensity to overcome absent sensation.

Review, progression and stopping

Repeat the same level when it is useful and repeatable. Reduce contact or pause the intervention after sustained worsening. Record the useful action achieved and any delayed symptoms. If no safe input is tolerable, prioritize access and reassessment; continued treatment does not require increasingly forceful stimulation.

The procedures are educational implementation examples requiring clinical adaptation, not validated standalone protocols. (Sources: 1, 2, 3)

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

Research and Sources

Professional consensus supports sensory input within rehabilitation. The examples here make that broad principle practical; they have not been validated as a fixed sensory-restoration protocol. Diagnostic research concerns assessment, not treatment efficacy.

Citation Full citation
[1] Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. JNNP. 2020;91:1037–1045. FND-CIT-0011. Source
[2] Nielsen G, Stone J, Matthews A, et al. Physiotherapy for functional motor disorders: a consensus recommendation. JNNP. 2015;86:1113–1119. FND-CIT-0028. Source
[3] Nielsen G, Higgins R, Stone J, Coebergh J, Edwards MJ. Functional sensory symptoms and signs: a case-control study of 102 patients. Brain Communications. 2026;8(1):fcag031. FND-CIT-0023. Source

Source check: September 15, 2026 · Occupational-therapy, physiotherapy, neurology, pain, equipment, lived-experience, supporter and accessibility review pending.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —