Sensory stimulation / sensory integration for Huntington´s disease

disease
Occupational therapist
Hanne Kristin Sigmond

Hospital in Kristiansand, Norway
hanne.kristin.sigmond@sshf.no

our whole lives. Every time we are in a new

situation receiving new sensory input, our brain must integrate these inputs, and at the same time build on the sensory inputs that is already integrated.
Disturbed ability to process sensory input have great consequences for how to perform activities.
Wrong interpretation of sensory inputs often leads to altered performing.

.
.

Sensory integration (SI) is also a specific treatment for improving the integration of sensory inputs.

Everything happens in the brain!

Huntington´s disease (HD) is loss of brain cells.
If we want better quality of life for a person with HD, we must influence the brain.

the behaviour  lack of social adaptation.

Will often be understood

as hyper activity or bad behaviour.

cell death in the brain.
It is found all over the

world.
Expected to live 15 – 20 years after having got the diagnosis, but great varieties.
«Dancing» movements, cognitive disorder, change of personality.

The cortex and basal ganglia is especially hit.
The basal ganglia regulates movements, change from one movement to another, change in muscle tone.
Gives lack of memory, of concentration, of initiative, irritability, strong angry outburst, depression, lack of speaking or understanding, eating disorder,
loss of weight.

unit for regulating muscle tone and wakening
and mental states.
Luria:

Three functional units of the brain

Receiving impulses from the specialists
(look, hear, feel,

motions)

Pass on to analyze

Associate / connect with earlier experiences

Conscious processes

VISUAL

SENSORY

AUDITORY

verification
of activity.
Get ideas
Make plans
Initiate motor movements
Control behaviour
Correct behaviour

Conscious processes
MOTOR

AREA

the brain.
Controls our emotional reactions.
All sensory inputs are connected

with feelings here.
Has great influence on our social behaviour.


Unconscious processes!

Hippocampus:
A direct way to our
long-term memory

Disturbed control of impulses
- Latency

Loss of planning skills: - Incontinence for

urine / stool
- Emotional incontinence

Loss of evaluation: - Indiscriminate
- Perseveration of movements / language
- Lack of inhibition

what to do

Injured right hemisphere:

Displace / deny
Euphoria
Projection
Overconfident

PERSEPTION
INTERPRETATION
CONSIDER
MAKE PLANS
PERFORME

UNIT 2

UNIT 3

UNIT 1

system (feeling on and under the skin):
Inside is me. Outside

in not me.

Proprioceptive system (tendons, muscles, joints):
Feel positions of the body.

Vestibular system (feeling of balance):
Position in room / weight / direction.

half asleep

Uneasy, restless, confuse

Low motivation

Affective changes – apathy / aggressive

Bodily

disturbances

movements, open up, stretch
Ice cube in face, on artery in

wrist
Smells: Coffee, vinegar, garlic, lemon (vary!)
Laughter is internal jogging 
Light and sound
Light touch
Small supporting area

awake and more active,
the brain needs something to react on.

rhythm
Chewing
Firm handling
Wrapping of body
Smells: Perfumes, oils
Vibration
Wide supporting area

stream of impulses to the CNS.
- increases body awareness,
the

patient feels the body borders,
and therefore feels more calm.

Blanket with balls

Blanket with chestnuts

Blanket with chains

health
Dementia
Neurological illnesses
Brain damages
Sleeping problems
Spasticity
Unrest and anxiety
Anorexia /bulimia
Elderly persons
Huntington

Chorea

techniques:
Heavy tools (during the night / in daytime)
Massage (face,

body)
Brushing (tactile sense, the boundaries of the body)
Pressing the joints together (the brain feels stability)
Rolling a ball on the body (the boundaries of the body)
Rocking (slow and soothing rhythm)
Vibration (feel your “bones”)
Music (calm, mute the pulse)

You can use several stimuli at the same time:
Blanket with weight + face massage + calm music
Brushing, then blanket with weight in a rocking chair + calm music

Birgitte Christensen Gammeltoft.

Price per brush: 35 DKK. (4,69 Euro)
A box

with 48 brushes costs 1.660 DKK. (222,55 Euro) incl. the shipment
+ customs (25 % to Norway!)

E-mail: kurt@gammeltoft.org
Website: www.gammeltoft.eu

of the body
Less involuntary movements
Become more independent in ADL
Better sleep
Better

circulation
Relaxation
Better breathing
Increased salivation (spit)
Better swallowing
Experience safety
Wellness

slow brushing back and forth. Hold the brush across.
Firm

brushing, but not hard. Try at yourself. Too soft brushing
is unpleasant.

Brush the back, arms and legs, also fingers and feet.
Try not to lift the brush off the body if possible.
Avoid the oval area:
Face, chest, stomach, inside of thighs – only on the outside.
On the back only down to the belt.

Preferably on bare skin. Stop when you have cowered
the skin, that is enough.

Think that you are giving the body back to the person 

in all joints.
Brushing increases sensibility and attention,
approximation is soothing.

Start

proximally:
Through the spine (sitting if possible)
Shoulders
Elbows
Wrist
Fingers
Hips
Knees
Ankles
Toes

Try to hold the joints in 0-position if possible
(straight).

stomach.
Roll the ball gently. Clothes are OK.
Start on the

back, vertical, horizontally, cower
the back with the ball.
Then the arms, from fingertips over
the shoulders to the other fingertips x 3 ?
From shoulder to toe and up x 3?
End on top of head.
Do not lift the ball from the body
at any time. Makes it predictable.
Do not press: We just want the brain to
be conscious of the feeling of the ball moving
around on the body, makes the brain relax.

Backside

in your stomach
and lean the patients head firm against

the pillow.
Lying: Stand behind the headboard of the bed.

Put a little facial cream mixed with two drops of for ex. lavender oil
on your fingertips, use both hands with parallel movements.
Start on the forehead, move down to the chin, following
the bone structure. Avoid eyes, nose, mouth.
Use firm pressure, but not hard.
Do not lift your fingers from the face. Makes it predictable.

Facial skin gives access directly to the limbic brain. Massage provides
good feelings and safety, which makes the patient relax.

the back.
Place the sheet over the patient.
Shove it under the

patient on one side (the opposite side from you).
Roll the patient over on the side, lying on the sheet.
Strap the sheet around the patient and place your knees on the sheet
so it is tight. The patient´s arms may lie on the chest or down along the side.
Stand on your knees and lean the patient´s back against your thighs.

Place one hand on the patient´s shoulder, the other on the hip.
Do the vibration 5 – 10 minutes, gently pressing against the bed.
Play some calm music in the background.