Apraxia post Apraxia post StrokeStroke

Paul MorrisPaul MorrisOccupational Therapist Occupational Therapist

GSTT GSTT

OverviewOverview

Explore what apraxia is Explore what apraxia is

The parts of the brain contribute to apraxiaThe parts of the brain contribute to apraxia

How apraxia can presentHow apraxia can present

Intervention techniques Intervention techniques

Task Performance Task Performance

All tasks require cognitive and perceptual All tasks require cognitive and perceptual components to complete themcomponents to complete them

Our ability to process the information in our Our ability to process the information in our environment has a direct impact on what we environment has a direct impact on what we can docan do

Praxis is an extremely important link Praxis is an extremely important link between brain and behaviour. This allows us between brain and behaviour. This allows us to interact with the world to interact with the world

Apraxia is…..Apraxia is…..

A reduced ability to interact with the A reduced ability to interact with the environment and physical world. environment and physical world.

The inability to perform skilled and The inability to perform skilled and purposeful motor tasks in the absence of purposeful motor tasks in the absence of motor deficits, paresis and paralysis. motor deficits, paresis and paralysis.

Apraxia Apraxia

Developmental DyspraxiaDevelopmental Dyspraxia

Acquired Apraxia: Resulting from CVA, Acquired Apraxia: Resulting from CVA, Traumatic Head Injury, Acquired Brain Injury Traumatic Head Injury, Acquired Brain Injury (hypoxia, encephalopathy and other (hypoxia, encephalopathy and other conditions) conditions)

Apraxia can be thought of being able to be Apraxia can be thought of being able to be broken into two distinct yet interactive broken into two distinct yet interactive components. Yet there are many components. Yet there are many subcategories that we come across in our subcategories that we come across in our practicepractice

Ideomotor Apraxia: inability to produce the Ideomotor Apraxia: inability to produce the correct movements and components of a correct movements and components of a task even though the individual retains the task even though the individual retains the concept of the taskconcept of the task

Ideational Apraxia: an inability to formulate Ideational Apraxia: an inability to formulate plans in order to execute tasks. plans in order to execute tasks.

So how might these presently differently? So how might these presently differently?

Ideomotor ApraxiaIdeomotor Apraxia

Difficulty imitating common movements or Difficulty imitating common movements or gesturesgestures

Difficulty with common tool useDifficulty with common tool use

Concept remains intact, it’s the executionConcept remains intact, it’s the execution

Poor control Poor control

Plane of movement and accuracy Plane of movement and accuracy

Ideational ApraxiaIdeational Apraxia

Inappropriate tool useInappropriate tool use

Sequence of task Sequence of task

OmissionsOmissions

Perseveration Perseveration

Use of own hand as a toolUse of own hand as a tool

Ideomotor ApraxiaIdeomotor Apraxia

Pre motor cortex of bilateral hemispheresPre motor cortex of bilateral hemispheres

Left inferior parietal lobeLeft inferior parietal lobe

Corpus callosum Corpus callosum

Basal gangliaBasal ganglia

ThalamusThalamus

Ideational ApraxiaIdeational Apraxia

Pre frontal and premotor cortex of bilateral Pre frontal and premotor cortex of bilateral hemispheres hemispheres

Left inferior parietal lobuleLeft inferior parietal lobule

Corpus callosumCorpus callosum

Intervention Intervention TechniquesTechniques

Tactile, kinesthetic and proprioceptive inputTactile, kinesthetic and proprioceptive input

Simple commandsSimple commands

Contextual environmentsContextual environments

SpontaneitySpontaneity

Reduced distractionsReduced distractions

Goal directed Goal directed

Questions?Questions?

Thank You.Thank You.