Assessment of ideomotor apraxia in patients with stroke and its effects on functional outcomes

Abstract

Objective: The aim of this study was to investigate ideomotor apraxia in patients with stroke and to evaluate the effects of presence of apraxia, hemiplegic side, and course of apraxia on functional outcomes. Materials and Methods: The study group included total 54 patients, 29 of whom with left hemisphere lesion and 25 of whom with right hemisphere lesion with right hand dominancy. The subjects were evaluated for apraxia by ideomotor apraxia test. Mini Mental State Examination test (MMSE) was applied in order to assess cognitive functions and Gülhane Aphasia Test (GAT), was used in order to assess language components at administration and at discharge. Activities of daily living were measured with Functional Independence Measure (FIM). Results: Eighteen of the 29 patients with left hemisphere lesion and 6 of the 25 patients with right hemisphere lesion were apraxic. Main effect of apraxia presence on FIM, MMSE and GAT scores was statistically significant. Related scores of apraxic patients were lower than non-apraxic patients. Main effect of hemiplegic side, hemiplegic side-apraxia presence and course of apraxia-apraxia presence on apraxia scores were statistically significant. It was found that main effect of hemiplegic side on FIM scores was not statistically significant however common effect of hemiplegic side-apraxia presence on FIM scores was statistically significant. It was showed that FIM scores can be predicted from apraxia scores. Conclusion: All patients benefited from neurological rehabilitation but apraxia presence decreased the gain. However at discharge daily living activities, cognitive and language functions of apraxic patients could not reach the same scores of non-apraxic patients at admission. For this reason especially patients with left hemisphere lesion should be evaluated for apraxia and apraxia levels should be determined.