Functional Rehabilitation of Upper Limb Apraxia in Patients Poststroke

Functional Rehabilitation of Upper Limb Apraxia in Patients Poststroke: Randomized Clinical Trial

The purpose of this study is to analyze the effects of a mixed intervention of occupational therapy (rehabilitative and compensatory approach) at home to upper limb apraxia in mild and moderate patients post stroke in comparison to a control group with a traditional health educative protocol.

Apraxia is a neurological disorder characterized by a loss of ability to execute and carry out skilled movements and gestures despite intact motor and sensory systems, coordination and comprehension.

Upper limb apraxia comprises a wide spectrum of higher motor disorders caused by acquired brain disease, affecting the performance of skilled movements carried out by the upper limbs.

Few data are available on the effectiveness of interventions in this disorder and no exists studies that implement a mixed intervention (rehabilitative and compensatory ) of Occupational Therapy in these patients at home.

Inclusion Criteria:

• Mild-moderate stroke after two month of the cerebrovascular attack.
• Upper limb apraxia lasting at least 2 months.
• Less than 9 points in validated Apraxia Screen of TULIA (AST) following Vanbellingen et al., 2010.
• Voluntary participation.
• The neurologist, the occupational therapist and the patient judge the intervention to be necessary.

Exclusion Criteria:

• History of apraxia before current stroke.
• Stroke had occurred less than two months or more than twenty four month ago.
• Cognitive impairment (< 23 in normal school population and < 20 points with a low education or illiteracy, in Spanish validation of Mini-Mental State Examination (MMSE)).
• Severe aphasia.
• Previous brain tumour.
• History of other previous neurologic disorders.
• Mother tongue different to Spanish.
• Drugs addiction.
• Intellectual or learning disorders.
• Brain damage for traumatism or neurodegenerative process.
• A history of serious consciousness impairments
• Uncooperativeness, presence of orthopedic or other disabling disorders.