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Current Neurology and Neuroscience... Jul 2023Apraxia of speech (AOS) is a motor speech disorder that has long been recognized to occur secondary to acute neurologic insults and, more recently, to neurodegenerative... (Review)
Review
PURPOSE OF REVIEW
Apraxia of speech (AOS) is a motor speech disorder that has long been recognized to occur secondary to acute neurologic insults and, more recently, to neurodegenerative diseases as a harbinger for progressive supranuclear palsy and corticobasal syndrome. This article reviews recent findings regarding the clinic phenotypes of AOS, neuroimaging correlates, and the underlying disease processes.
RECENT FINDINGS
Two clinical subtypes of AOS map onto two underlying 4-repeat tauopathies. New imaging techniques have recently been applied to the study of progressive AOS. There is no data on the impact of behavioral intervention, although studies of nonfluent/agrammatic primary progressive aphasia that include patients with AOS suggest some benefit in speech intelligibility and maintenance. While recent findings suggest subtypes of AOS exist that are linked to molecular pathology and have important implications for disease progression, further research is needed to assess outcome of behavioral and other types of intervention.
Topics: Humans; Speech; Apraxias; Supranuclear Palsy, Progressive; Neuroimaging; Neurodegenerative Diseases
PubMed: 37269450
DOI: 10.1007/s11910-023-01275-1 -
CoDAS 2019Apraxia of speech is defined as the inability to sequence the movements required for accurate articulatory production, traditionally involving a deficit in speech motor...
Apraxia of speech is defined as the inability to sequence the movements required for accurate articulatory production, traditionally involving a deficit in speech motor programming. Language clinicians often confront about speech inconsistency clinical cases, which raise questions concerning the differential diagnosis between apraxia and language disorders. Such problem often results in the difficulty to establish an adequate treatment decision. In this work, we discuss a clinical report in which both diagnosis and treatment raise questions about the apraxic speech condition in childhood. We start from the recognition that, in apraxia, it seems imperative to consider that the body to be considered is the one that surpasses its organic functions and structure. Clinical consequences are drawn from the premise that the human body is one whose ear can listen, and mouth can speak, i.e., the organic structure is a material realm open to the incidence of language and its "music", which creates the speaking body.
Topics: Apraxias; Child, Preschool; Diagnosis, Differential; Female; Humans; Language Development Disorders; Language Therapy; Speech Disorders; Speech Production Measurement
PubMed: 31691745
DOI: 10.1590/2317-1782/20192018121 -
Revista de Neurologia Mar 2020Freezing of gait (FOG) is one of the most severe symptoms associated with Parkinson's disease (PD). Physiotherapy treatment could be an effective strategy for treating... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Freezing of gait (FOG) is one of the most severe symptoms associated with Parkinson's disease (PD). Physiotherapy treatment could be an effective strategy for treating FOG, but no systematic review has been carried out in this regard.
AIM
To identify the characteristics, methodological quality, and main outcomes of the studies that have analyzed the effects of physiotherapy interventions in FOG up to date, by performing a systematic review and a meta-analysis.
PATIENTS AND METHODS
Four electronic databases were searched in order to find randomized controlled trials that provided information regarding the effects of any kind of physiotherapy treatment on FOG. The methodological quality of the included investigations was assessed by means of the PEDro scale.
RESULTS
Twelve studies were identified for inclusion into the qualitative analysis, with four randomized controlled trials included in the final meta-analysis. The quality of the trials was generally good. Those physiotherapy modalities including cues were more effective for treating FOG than traditional physiotherapy approaches. The meta-analysis indicated that physiotherapy interventions had a significantly greater impact on FOG than control comparisons.
CONCLUSIONS
Physiotherapy treatment, especially those modalities including visual and auditory cueing, should be prescribed to PD patients with FOG. Future studies including PD patients with cognitive impairment and FOG objective measurement tools are need to complete the existing scientific evidence.
Topics: Data Accuracy; Gait Apraxia; Humans; Parkinson Disease; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 32100276
DOI: 10.33588/rn.7005.2019417 -
American Journal of Speech-language... Feb 2020Purpose The purpose of this article is to describe a treatment approach, Dynamic Temporal and Tactile Cueing (DTTC), and to provide clinicians and clinical researchers a... (Review)
Review
Purpose The purpose of this article is to describe a treatment approach, Dynamic Temporal and Tactile Cueing (DTTC), and to provide clinicians and clinical researchers a clear understanding of the theory and principles that contributed to the design of the treatment as well as the clinical decisions that must be made when implementing it. While brief descriptions of DTTC have been provided in textbooks, a complete summary of the rationale, essential elements, method, and procedures has not yet been published. Such a summary is important so that clinicians can gain a better understanding of and more confidence in using the method for appropriate children. Furthermore, this article provides clinicians and clinical researchers essential information for measurement of fidelity. Method The important elements of the DTTC method with rationale for their inclusion are described. The temporal hierarchy of DTTC is depicted, and the dynamic procedure is described in detail, with suggestions for fidelity measurement. Finally, a discussion of important decisions clinicians must make when implementing DTTC is presented. Conclusions The goal of DTTC is to improve the efficiency of neural processing for the development and refinement of sensorimotor planning and programming. The rationale for DTTC in general, as well as the key elements important to its administration, are supported by models of speech production and theories of motor learning. Important clinical decisions regarding stimuli, organization of practice, and feedback are based on principles of motor learning in order to facilitate acquisition, retention, and continued improvement of motor speech skills.
Topics: Apraxias; Child; Cues; Humans; Motor Skills; Speech Disorders; Speech-Language Pathology
PubMed: 31846588
DOI: 10.1044/2019_AJSLP-19-0005 -
Continuum (Minneapolis, Minn.) Dec 2021Limb apraxia is one of the most common and most disabling disorders caused by brain damage. However, apraxia is one of the least recognized disorders associated with... (Review)
Review
PURPOSE OF REVIEW
Limb apraxia is one of the most common and most disabling disorders caused by brain damage. However, apraxia is one of the least recognized disorders associated with cerebral disease. This article discusses the signs and symptoms of, means of testing for, the pathophysiology of, and possible management of upper limb apraxia.
RECENT FINDINGS
Upper limb apraxia has four major forms: ideomotor, limb-kinetic, conceptual, and ideational. Although recent findings are included in this article, a full understanding of these disorders, including the means of testing, their possible pathophysiology, and the diseases that may cause these disorders, requires that some older literature is also discussed.
SUMMARY
This article guides clinicians in testing for and diagnosing the different forms of upper limb apraxia, identifying the underlying diseases that may cause apraxia, managing the different forms of the disorder, and possible forms of rehabilitation.
Topics: Apraxias; Humans; Upper Extremity
PubMed: 34881728
DOI: 10.1212/CON.0000000000001014 -
La Clinica Terapeutica 2020Apraxia affects 20% of the right brain-damaged patients and 50% of the left brain-damaged patients. This disorder of motor programming reduces patients' independence and... (Meta-Analysis)
Meta-Analysis
Apraxia affects 20% of the right brain-damaged patients and 50% of the left brain-damaged patients. This disorder of motor programming reduces patients' independence and there are few guidelines on the rehabilitative treatment in the physiotherapy and speech therapy field.The aim of this study was to assess which therapeutic interventions are the most effective in stroke patients with apraxia in considering the mentioned purviews. Four databases were systematically searched in order to detect all available studies investigating the physical and speech rehabilitation of patients. The literature research produced five studies including 168 patients for the physiotherapy and 50 for speech therapy fields; two were eligible for meta-analysis. Quality was rated with Jadad, PEDro scale and Cochrane Risk Of Bias Tool. Both for physiotherapy and speech therapy fields, the RCTs interventions obtained statistically significant results for outcomes of interest. Despite this, it is still not possible to determine the best approach due to the low number of patients involved, the lack of maintenance of the results at follow up and the timing of the revaluation period being very short to confirm the efficacy of treatments.
Topics: Apraxias; Humans; Physical Therapy Modalities; Speech Therapy; Stroke
PubMed: 32901792
DOI: 10.7417/CT.2020.2257 -
Handbook of Clinical Neurology 2020Motor development includes the evolution from reflexive to voluntary and goal-directed motor actions. These motor actions are never performed in isolation but always in...
Motor development includes the evolution from reflexive to voluntary and goal-directed motor actions. These motor actions are never performed in isolation but always in a varying physical environment, often requiring object and social interaction. For a child to function within this context, they require the ability to demonstrate skillful, efficient, and voluntary postures and movement patterns. Furthermore, these movement patterns or motor skills need to be performed in interaction with the environment and in response to diverse stimuli, an ability that is defined as praxis. In this chapter, definitions are provided for the different components of motor function, motor skills, and praxis. The close interaction between perception, cognition, and (motor) action is discussed. Furthermore, crucial periods of typical development of motor and praxis abilities are highlighted, by means of the metaphorical "mountain of motor development," that is rooted in the dynamic systems perspective on motor development, as a starting point. The chapter ends with a discussion on the evaluation of motor function and praxis, highlighting benefits, and possible pitfalls.
Topics: Apraxias; Humans; Motor Skills
PubMed: 32958171
DOI: 10.1016/B978-0-444-64150-2.00015-0 -
Handbook of Clinical Neurology 2021This chapter starts by reviewing the various interpretations of Bálint syndrome over time. We then develop a novel integrative view in which we propose that the various...
This chapter starts by reviewing the various interpretations of Bálint syndrome over time. We then develop a novel integrative view in which we propose that the various symptoms, historically reported and labeled by various authors, result from a core mislocalization deficit. This idea is in accordance with our previous proposal that the core deficit of Bálint syndrome is attentional (Pisella et al., 2009, 2013, 2017) since covert attention improves spatial resolution in visual periphery (Yeshurun and Carrasco, 1998); a deficit of covert attention would thus increase spatial uncertainty and thereby impair both visual object identification and visuomotor accuracy. In peripheral vision, we perceive the intrinsic characteristics of the perceptual elements surrounding us, but not their precise localization (Rosenholtz et al., 2012a,b), such that without covert attention we cannot organize them to their respective and recognizable objects; this explains why perceptual symptoms (simultanagnosia, neglect) could result from visual mislocalization. The visuomotor symptoms (optic ataxia) can be accounted for by both visual and proprioceptive mislocalizations in an oculocentric reference frame, leading to field and hand effects, respectively. This new pathophysiological account is presented along with a model of posterior parietal cortex organization in which the superior part is devoted to covert attention, while the right inferior part is involved in visual remapping. When the right inferior parietal cortex is damaged, additional representational mislocalizations across saccades worsen the clinical picture of peripheral mislocalizations due to an impairment of covert attention.
Topics: Apraxias; Attention; Cogan Syndrome; Humans; Parietal Lobe; Perceptual Disorders; Space Perception; Visual Perception
PubMed: 33832679
DOI: 10.1016/B978-0-12-821377-3.00011-8 -
Rhode Island Medical Journal (2013) Mar 2022
Topics: Apraxias; Humans
PubMed: 35211706
DOI: No ID Found