-
Progress in Brain Research 2007Praxic functions are frequently altered following brain lesion, giving rise to apraxia - a complex pattern of impairments that is difficult to assess or interpret. In... (Review)
Review
Praxic functions are frequently altered following brain lesion, giving rise to apraxia - a complex pattern of impairments that is difficult to assess or interpret. In this chapter, we review the current taxonomies of apraxia and related cognitive and neuropsychological models. We also address the questions of the neuroanatomical correlates of apraxia, the relation between apraxia and aphasia and the analysis of apraxic errors. We provide a possible explanation for the difficulties encountered in investigating apraxia and also several approaches to overcome them, such as systematic investigation and modeling studies. Finally, we argue for a multidisciplinary approach. For example, apraxia should be studied in consideration with and could contribute to other fields such as normal motor control, neuroimaging and neurophysiology.
Topics: Apraxias; Functional Laterality; Humans; Models, Biological
PubMed: 17920426
DOI: 10.1016/S0079-6123(07)64004-7 -
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 -
Parkinsonism & Related Disorders May 2018"Apraxia of gait" is not a useful concept and freezing of gait should also not be considered an apraxia. The concept of apraxia may, however, be applied to distortions... (Review)
Review
"Apraxia of gait" is not a useful concept and freezing of gait should also not be considered an apraxia. The concept of apraxia may, however, be applied to distortions of postural transitions that can accompany fronto-parietal lesions.
Topics: Apraxias; Gait Apraxia; Gait Disorders, Neurologic; Humans; Postural Balance; Terminology as Topic
PubMed: 29477458
DOI: 10.1016/j.parkreldis.2018.02.024 -
NeuroImage. Clinical 2014Apraxia, a disorder of higher motor cognition, is a frequent and outcome-relevant sequel of left hemispheric stroke. Deficient pantomiming of object use constitutes a... (Review)
Review
Apraxia, a disorder of higher motor cognition, is a frequent and outcome-relevant sequel of left hemispheric stroke. Deficient pantomiming of object use constitutes a key symptom of apraxia and is assessed when testing for apraxia. To date the neural basis of pantomime remains controversial. We here review the literature and perform a meta-analysis of the relevant structural and functional imaging (fMRI/PET) studies. Based on a systematic literature search, 10 structural and 12 functional imaging studies were selected. Structural lesion studies associated pantomiming deficits with left frontal, parietal and temporal lesions. In contrast, functional imaging studies associate pantomimes with left parietal activations, with or without concurrent frontal or temporal activations. Functional imaging studies that selectively activated parietal cortex adopted the most stringent controls. In contrast to previous suggestions, current analyses show that both lesion and functional studies support the notion of a left-hemispheric fronto-(temporal)-parietal network underlying pantomiming object use. Furthermore, our review demonstrates that the left parietal cortex plays a key role in pantomime-related processes. More specifically, stringently controlled fMRI-studies suggest that in addition to storing motor schemas, left parietal cortex is also involved in activating these motor schemas in the context of pantomiming object use. In addition to inherent differences between structural and functional imaging studies and consistent with the dedifferentiation hypothesis, the age difference between young healthy subjects (typically included in functional imaging studies) and elderly neurological patients (typically included in structural lesion studies) may well contribute to the finding of a more distributed representation of pantomiming within the motor-dominant left hemisphere in the elderly.
Topics: Apraxias; Gestures; Humans; Magnetic Resonance Imaging; Neuroimaging; Parietal Lobe; Psychomotor Performance
PubMed: 24967158
DOI: 10.1016/j.nicl.2014.05.017 -
Practical Neurology Dec 2017
Topics: Apraxias; Humans; Neurologic Examination; Neuropsychological Tests
PubMed: 28626022
DOI: 10.1136/practneurol-2016-001526 -
Cortex; a Journal Devoted To the Study... Jul 2018
Topics: Apraxias; Brain Diseases; Brain Injuries; Diagnosis, Differential; Humans
PubMed: 29587996
DOI: 10.1016/j.cortex.2018.02.015 -
Journal of Stroke and Cerebrovascular... Feb 2023Limb apraxia, a complication of stroke, causes difficulties in performing activities of daily living (ADL). To date, there are no studies on the effectiveness of limb... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Limb apraxia, a complication of stroke, causes difficulties in performing activities of daily living (ADL). To date, there are no studies on the effectiveness of limb apraxia interventions. We conducted a meta-analysis to assess the effectiveness of limb apraxia interventions in reducing its severity and improving ADL.
METHODS
We conducted a search of randomized controlled trials (RCTs) related to limb apraxia till December 2021 using the databases of PubMed, Embase, CINAHL, and the Cochrane Library. We measured the outcome variables in the subgroups of total apraxia (TA), ideational apraxia (IA), ideomotor apraxia (IMA), and ADL. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality.
RESULTS
Five RCTs were selected, and of the 310 participants, 155 were in the experimental and 155 in the control group. A random-effects model was used for the effect size distribution. The limb apraxia intervention methods included gesture and strategy training (three and two studies, respectively). The effect sizes of the outcome variables in the subgroups were small for the TA and IA, with 0.475 (95% confidence interval [CI]: -0.151-1.102; p = 0.137) and 0.289 (95% CI: -0.144-0.722; p = 0.191), respectively. IMA had a medium effect size of 0.731 (95% CI: -0.062-1.525; p = 0.071), not statistically significant, whereas ADL effect size was small and statistically significant, 0.416 (95% CI: 0.159-0.673; p = 0.002).
CONCLUSIONS
Gesture and strategy training had statistically significant effects on ADL as limb apraxia interventions. Therefore, the effectiveness of the apraxia interventions needs to be further evaluated through continuous RCTs.
Topics: Humans; Activities of Daily Living; Stroke Rehabilitation; Randomized Controlled Trials as Topic; Stroke; Apraxias
PubMed: 36512886
DOI: 10.1016/j.jstrokecerebrovasdis.2022.106921 -
Handbook of Clinical Neurology 2013Apraxia is a cognitive-motor disorder that impacts the performance of learned, skilled movements. Limb apraxia, which is the topic of this chapter, is specific to... (Review)
Review
Apraxia is a cognitive-motor disorder that impacts the performance of learned, skilled movements. Limb apraxia, which is the topic of this chapter, is specific to disordered movements of the upper limb that cannot be explained by weakness, sensory loss, abnormalities of posture/tone/movement, or a lack of understanding/cooperation. Patients with limb apraxia have deficits in the control or programming of the spatial-temporal organization and sequencing of goal-directed movements. People with limb apraxia can have difficulty manipulating and using tools including cutting with scissors or making a cup of coffee. Two praxis systems have been identified including a production system (action plan and production) and a conceptual system (action knowledge). Dysfunction of the former produces ideomotor apraxia (e.g., difficulty using scissors), and dysfunction of the latter induces ideational apraxia (e.g., difficulty making a cup of coffee). Neural mechanisms, including how to evaluate apraxia, will be presented in the context of these two praxis systems. Information about these praxis systems, including the nature of the disordered limb movement, is important for rehabilitation clinicians to understand for several reasons. First, limb apraxia is a common disorder. It is common in patients who have had a stroke, in neurodegenerative disorders like Alzheimer disease, in traumatic brain injury, and in developmental disorders. Second, limb apraxia has real world consequences. Patients with limb apraxia have difficulty managing activities of daily living. This factor impacts healthcare costs and contributes to increased caregiver burden. Unfortunately, very few treatments have been systematically studied in large numbers of patients with limb apraxia. This overview of limb apraxia should help rehabilitation clinicians to educate patients and caregivers about this debilitating problem, and should facilitate the development of better treatments that could benefit many people in the future.
Topics: Animals; Apraxias; Cerebral Cortex; Functional Laterality; Humans; Recovery of Function; Stroke
PubMed: 23312653
DOI: 10.1016/B978-0-444-52901-5.00028-9 -
NeuroRehabilitation 2011Apraxia is a higher-order motor disorder impairing the ability to correctly perform skilled, purposive movements as the result of neurological disorders most commonly... (Review)
Review
Apraxia is a higher-order motor disorder impairing the ability to correctly perform skilled, purposive movements as the result of neurological disorders most commonly stroke, dementia and movement disorders. It is increasingly recognised that apraxia negatively influences activities of daily living (ADL). Early diagnosis and treatment should be part of the neurorehabilitation programme. The aim of the present article is to describe the most important subtypes of apraxia such as ideational and ideomotor apraxia as well as their impact on ADL and outcome. Furthermore, the relationship to associated disorders such as aphasia is discussed. Finally, strategies concerning assessment, management and treatment of the disorder are presented.
Topics: Activities of Daily Living; Apraxias; Humans; Recovery of Function
PubMed: 21447909
DOI: 10.3233/NRE-2011-0637 -
Medizinische Klinik (Munich, Germany :... Jan 2006Apraxia is the disturbance of planning and of execution of motor activity. It is not caused by a lesion or a disturbance of the motor or sensory nervous system, it is... (Review)
Review
Apraxia is the disturbance of planning and of execution of motor activity. It is not caused by a lesion or a disturbance of the motor or sensory nervous system, it is elicited by a dysfunction of an area in the left cortex of the brain. This area in the left fronto-parietotemporal hemisphere is located right beside the area for speech. Therefore it is not unusual that patients with apraxia suffer from aphasia as well. The two different types of limb apraxia are ideomotor apraxia and ideational apraxia. Ideomotor apraxia is apraxia without tool use, it includes imitation of positions of hands and fingers, performance of gestures on demand, and pantomime of object use. Ideational apraxia is apraxia with tool use like cutting with a knife or utilizing a pencil.
Topics: Aphasia; Apraxia, Ideomotor; Apraxias; Extremities; Gestures; Humans; Movement; Neuropsychology
PubMed: 16418811
DOI: 10.1007/s00063-006-1001-4