Diagnosis and treatment of upper limb apraxia

Dovern, Anna; Fink, Gereon R.; Weiss, Peter H.

doi:10.1007/s00415-011-6336-y

Cited by 87 publications

(77 citation statements)

References 69 publications

(153 reference statements)

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“…462 Two reviews concluded that there was not enough information to determine whether interventions for apraxia were efficacious. 458,459 Some studies have found immediate postintervention improvements on apraxia tests or in daily life activities, but few have found lasting advantages for the trained groups.…”

Section: Limb Apraxiamentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,169

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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Section: Limb Apraxiamentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,169

840

View full text Add to dashboard Cite

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“…The findings of the current study have important implications for the development of novel treatment strategies of apraxia (Buxbaum et al, 2008;Dovern et al, 2011). The data suggest that such strategies should include incidental motor learning and thereby make use of the remaining motor learning resources of patients with apraxia.…”

Section: Discussionmentioning

confidence: 60%

Apraxia Impairs Intentional Retrieval of Incidentally Acquired Motor Knowledge

Dovern¹,

Fink²,

Saliger³

et al. 2011

J. Neurosci.

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Apraxia caused by left hemispheric stroke typically impairs skilled sequential movements. After stroke, apraxic patients need to reacquire motor skills by motor learning. The current study assessed for the first time incidental motor sequence learning in apraxic patients. Forty-eight human subjects (henceforth called "patients") with left hemispheric stroke affecting the middle cerebral artery territory (18 with apraxia and 30 without apraxia) and 17 age-matched healthy controls were tested on a visuomanual serial reaction time task. Subjects performed four blocks consisting of repetitions of a complex six element sequence containing ambiguous pairwise transitions before a new and unfamiliar sequence was introduced in block 5. Reaction time (RT) disadvantages in this fifth block indicated incidental sequence-specific motor learning. The intentional retrieval of the learned motor knowledge was assessed subsequently with a free recall task. Voxel-based lesion-symptom mapping (VLSM) was performed to investigate for the first time the lesion correlates of deficits in learning and retrieving sequential motor knowledge. Despite generally prolonged RTs, apraxic patients showed sequence-specific motor learning as could be observed in nonapraxic patients and healthy controls. However, apraxic patients showed reduced intentional retrieval of the learned sequence. VLSM revealed that impaired intentional retrieval of motor sequence knowledge resulted from dorsal premotor cortex lesions. Apraxic patients showed a dissociation of preserved incidental motor (sequence) learning and deficient intentional retrieval of this incidentally learned motor knowledge. The data suggest that novel approaches for treating apraxia should focus on incidental motor learning, but that automatic rather than intentional retrieval strategies should be enforced.

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“…Definitions and taxonomies of apraxia and its subcomponents are diverse and competing cognitive models disagree in the definition of domains that essentially constitute the syndrome 2 3. However, dysfunctions in imitation and pantomime on command have been proposed as the core features of the syndrome 4.…”

Section: Introductionmentioning

confidence: 99%

“…However, dysfunctions in imitation and pantomime on command have been proposed as the core features of the syndrome 4. This descriptive division of praxis domains and subdomains (figure 1) has overcome a range of definitional and practical issues in apraxia research and has thus been adopted by modern apraxia screening tests for patients with stroke 2 3…”

Section: Introductionmentioning

confidence: 99%