The involvement of altered sensory modulation in neurological conditions and its relevance to neuro-rehabilitation: a narrative literature review

Purpose: Neurological conditions are frequently described and treated with emphasis on primarily body dysfunctions that appear in the diagnostic criteria. This perspective paper aims to provide knowledge about the involvement of secondary body dysfunctions–altered sensory modulation–in neurological conditions and their relevance to neuro-rehabilitation. This paper refers to children and adults, to provide a life span view. Health models and approaches are discussed to bring ideas for optimizing rehabilitation. Methods: Perspective based on narrative literature review. Results: Altered sensory modulation is prevalent in neurological conditions. It is related to clinical symptoms, comorbidities and severity level. Many studies focus on specific modalities and on laboratory/clinical measurements. However, information gathered from subjective measures reflects the alterations in various sensory modalities and their negative impacts on the individuals’ daily activity performance, participation and quality of life (QOL). Conclusions: Neuro-rehabilitation should consider altered sensory modulation in neurological conditions, apply health models with broad perspective, as the ICF, with multi-disciplinary team, objective and subjective measures to understand how pathogenic mechanisms in primary and secondary body dysfunctions impact the performance and participation in daily life. This approach may optimize the individuals’ involvement in therapy, enhance daily function and QOL and elevate intervention success.Implications for rehabilitation Sensory modulation should be evaluated in children and adults with neurologic conditions. The evaluation and intervention should refer to the involvement of altered sensory modulation in the conditions’ clinical characteristics, severity and comorbidities. In case altered sensory modulation is found, the evaluation and intervention should incorporate a multi-disciplinary collaboration and health models such as the ICF model, to optimize neuro-rehabilitation efficiency. Objective measures should be applied to profile altered sensory modulation and its role in pathogenic mechanisms. Subjective measures should also be used to reflect the expressions of altered sensory modulation as experienced by the individual (and family members), in daily life scenarios. By bridging between the clinic and the individuals’ real-life context, rehabilitation process and outcomes may be optimized, in terms of the individual’s greater involvement in therapy, better function and quality of life.