Apraxia post Stroke - the HIEC Stroke Events Website

Apraxia post Stroke Paul Morris Occupational Therapist GSTT

Overview  Explore what apraxia is  The parts of the brain contribute to apraxia  How apraxia can present  Intervention techniques

Task Performance  All tasks require cognitive and perceptual components to

complete them  Our ability to process the information in our environment

has a direct impact on what we can do  Praxis is an extremely important link between brain and

behaviour. This allows us to interact with the world

Apraxia is….. A reduced ability to interact with the environment and physical world. The inability to perform skilled and purposeful motor tasks in the absence of motor deficits, paresis and paralysis.

Apraxia  Developmental Dyspraxia  Acquired Apraxia: Resulting from CVA, Traumatic Head

Injury, Acquired Brain Injury (hypoxia, encephalopathy and other conditions)  Apraxia can be thought of being able to be broken into

two distinct yet interactive components. Yet there are many subcategories that we come across in our practice

 Ideomotor Apraxia: inability to produce the correct

movements and components of a task even though the individual retains the concept of the task  Ideational Apraxia: an inability to formulate plans in order

to execute tasks. So how might these presently differently?

Ideomotor Apraxia  Difficulty imitating common movements or gestures  Difficulty with common tool use  Concept remains intact, it’s the execution  Poor control  Plane of movement and accuracy

Ideational Apraxia  Inappropriate tool use  Sequence of task  Omissions  Perseveration  Use of own hand as a tool

Ideomotor Apraxia  Pre motor cortex of bilateral hemispheres  Left inferior parietal lobe  Corpus callosum  Basal ganglia  Thalamus

Ideational Apraxia  Pre frontal and premotor cortex of bilateral hemispheres

 Left inferior parietal lobule

 Corpus callosum

Intervention Techniques  Tactile, kinesthetic and proprioceptive input  Simple commands  Contextual environments  Spontaneity  Reduced distractions  Goal directed

Questions?

Thank You.