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APRAXIA

DEFINITION: Apraxia is a neurological condition in where a person has difficulty performing learned movements even though they have adequate strength and understand the task.

COMMON CONDITIONS:

1. Stroke

2. Traumatic Brain Injury

3. Dementia

4. Cortical lesions

5. Neurodegenerative Disorders

CLINIAL EXAMPLE:

1. A patient is given a toothbrush but he/she unable to demonstrate how to brush their teeth, even though they understand the task and have the physical ability to perform it.

2. A Patient is asked to show how to use a comb but they move their hand randomly without performing the the correct action. 

TYPES OF APRAXIA:

1. Ideomotor apraxia - Difficulty performing tasks on command even though the person understands the task. 

2. Ideational apraxia - Difficulty Planning and Sequencing a series of actions needed to complete a task involving objects. 

3. Constructional apraxia - Difficulty constructing or drawing objects such as copying shapes or arranging blocks.

4. Dressing apraxia - Difficulty performing the movements required to put on clothes correctly. 

5. Bucco facial apraxia (oral)  - Difficulty performing movements with the face, lips or tongue such as blowing, whistling.

ASSESSMENT METHODS:

1. Gesture imitation test: The therapist should ask the patient to imitate simple gestures such as waving, saluting. 

👉 (Purpose: To identify difficulties in Motor planning and Execution of movements)

2. Object use  test: The therapist should give an object to the patient like toothbrush, comb, spoon and asked to demonstrate how they use them. 

👉 (Purpose: To evaluate recognizing objects and functional actions)

3. Multitask Performance: The patient is asked to perform a sequence of actions such as preparing of cup of tea. 

👉 (purpose: To evaluate ability to plan, initiate and execute task)

4. ADL Observation: Therapist should observe the patients while performing their ADL such as Dressing, Grooming or Eating. 

👉 (Purpose: To identify practical difficulties caused by apraxia in everyday functional tasks)

OT INTERVENTION IDEAS:

1. Task demonstration and imitation training

2. Step-by-step verbal cueing

3. Hand-over-hand guidance

4. Repetitive functional task practice

5. Environmental structuring for ADL tasks

CLINICAL TIP: Apraxia often becomes more visible during functional tasks such as dressing, grooming, and tool use, rather than during isolated movement testing.

RELATED TOPICS: Dyspraxia | Motor Planning | ADL training | Cognitive Rehabilitation