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Meta-Analysis
. 2008 Jan 23;2008(1):CD004132.
doi: 10.1002/14651858.CD004132.pub2.

Interventions for motor apraxia following stroke

C West, A Bowen, A Hesketh, A Vail
Meta-Analysis

Interventions for motor apraxia following stroke

C West et al. Cochrane Database Syst Rev. .

Abstract

Background: Apraxia is a cognitive disorder that can occur after stroke. It prevents a person from carrying out a learned movement. Various interventions are used to treat apraxia but evidence of their benefit has been lacking.

Objectives: To determine which therapeutic interventions targeted at motor apraxia reduce disability.

Search strategy: We searched the Cochrane Stroke Group Trials Register (last searched November 2006). In addition, we searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2006), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2006), CINAHL (1982 to November 2006), PsycINFO (1974 to November 2006), the Research Index of the Occupational Therapy Journal (searched November 2006), REHABDATA (1956 to November 2006), the National Research Register (searched November 2006) and Current Controlled Trials Register (searched November 2006). We reviewed the reference lists of all articles that we identified as relevant. We made efforts to find both published and unpublished trials by writing to key authors and journals.

Selection criteria: Randomised controlled trials of therapeutic intervention for motor apraxia in stroke.

Data collection and analysis: One review author searched the titles, abstracts and keywords. Four review authors extracted data and analysed trial quality. We contacted investigators for further details of trials if necessary.

Main results: Three trials including a total of 132 participants were included in the review. There was evidence of a small and short-lived therapeutic effect in the two studies that reported change in activities of daily living (102 participants) but this was not considered clinically significant and did not persist at the longer-term follow up.

Authors' conclusions: There is insufficient evidence to support or refute the effectiveness of specific therapeutic interventions for motor apraxia after stroke. Further research of higher quality is required. As we did not review whether patients with apraxia benefit from rehabilitation input in general, they should continue to receive general stroke rehabilitation services.

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Conflict of interest statement

None known

Figures

1.1
1.1. Analysis
Comparison 1 Experimental therapy versus standard care, Outcome 1 Change in Barthel at six months after end of therapy.
1.2
1.2. Analysis
Comparison 1 Experimental therapy versus standard care, Outcome 2 Change in Barthel at end of therapy.
1.4
1.4. Analysis
Comparison 1 Experimental therapy versus standard care, Outcome 4 Death.
1.6
1.6. Analysis
Comparison 1 Experimental therapy versus standard care, Outcome 6 Ability to gesture, pantomime, use real objects.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD004132

References

References to studies included in this review

Donkervoort 2001 {published data only}
    1. Donkervoort M, Dekker J, Stehmann‐Saris FC, Deelman BG. Efficacy of strategy training in left hemisphere stroke patients with apraxia: a randomised clinical trial. Neuropsychological Rehabilitation 2001;11(5):549‐66.
Edmans 2000 {published and unpublished data}
    1. Edmans JA, Webster J, Lincoln NB. A comparison of two approaches in the treatment of perceptual problems after stroke. Clinical Rehabilitation 2000;14:230‐43. - PubMed
Smania 2000 {published data only}
    1. Smania N, Girardi F, Domenicali C, Lora E, Aglioti S. The rehabilitation of limb apraxia: a study in left‐brain‐damaged patients. Archives of Physical Medicine and Rehabilitation 2000;81:379‐88. - PubMed

Additional references

Blais 1994
    1. Blais M. Literature review. Directorate of Public Health Medicine. Northamptonshire Health Authority 1994.
Butler 1994
    1. Butler JA. Intervention effectiveness: evidence from a case study of ideomotor and ideational apraxia. British Journal of Occupational Therapy 1997;60(11):491‐7.
Butler 2002
    1. Butler. How comparable are tests of apraxia?. Clinical Rehabilitation 2002;16:389‐98. - PubMed
De Renzi 1980
    1. Renzi E, Motti F, Nichelli P. Imitating gestures: a quantitative approach to ideomotor apraxia. Archives of Neurology 1980;37:6‐10. - PubMed
Fisher 1994
    1. Fisher AG. Development of a functional assessment that adjusts ability measures for task simplicity and rater leniency. In: Wilson M editor(s). Objective Measurement: Theory into Practice. Norwood: Ablex, 1994.
Geschwind 1975
    1. Geschwind N. The apraxias: neural mechanisms of disorders of learned movements. American Scientist 1975;63:188‐95. - PubMed
Geschwind 1985
    1. Geschwind N, Damasio AR. Apraxia. In: Fredricks editor(s). Handbook of Clinical Neurology. Vol. 1(45), Amsterdam: Elsevier, 1985:423‐32.
Goldenberg 1998
    1. Goldenberg G, Hagmann S. Therapy of activities of daily living in patients with apraxia. Neuropsychological Rehabilitation 1998;8(2):123‐41.
Heilman 1985
    1. Heilman K, Rothi LJG. Apraxia. In: Heilman KM, Valenstein E editor(s). Clinical Neuropsychology. 2nd Edition. Oxford: Oxford University Press, 1985.
Jackson 1999
    1. Jackson T. Dyspraxia: Guidelines for intervention. British Journal of Occupational Therapy 1999;62(7):321‐6.
Kareken 1998
    1. Kareken DA, Unverzagt F, Caldemeyer K, Farlow MR, Hutchins GD. Functional brain imaging in apraxia. Archives of Neurology 1998;55(1):107‐13. - PubMed
Keith 1987
    1. Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. In: Eisenberg NG, Grzesiak RC editor(s). Advances in Clinical Rehabilitation. New York: Springer, 1987. - PubMed
Kertesz 1984
    1. Kertesz A, Ferro JM. Lesion size and location in ideomotor apraxia. Brain 1984;107:921‐33. - PubMed
Liepmann 1920
    1. Liepmann H. Apraxia. Ergebnisse der Gesamten Medizin 1920;1:516‐43.
Liepmann 1905
    1. Liepmann H. The left hemisphere and action. London, Ontario: University of Western Ontario, 1905.
Mahoney 1965
    1. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Maryland State Medical Journal 1965;14:61‐5. - PubMed
Rothi 1997
    1. Rothi LJG, Heilman KM. Apraxia: The Neuropsychology of Action. Hove: Psychology Press, 1997.
Sundet 1988
    1. Sundet K, Finset A, Reinvang I. Neuropsychological predictors in stroke rehabilitation. Journal of Clinical and Experimental Neuropsychology 1988;10:363‐9. - PubMed
Tate 1995
    1. Tate R, McDonald S. What is apraxia? The clinician's dilemma. Neuropsychological Rehabilitation 1995;5(4):273‐97.
Van Heugten 1998
    1. Heugten CM, Dekker J, Deelman BG, Dijk AJ, Stehmann‐Saris JC, Kinebanian A. Outcome of strategy training in stroke patients with apraxia: A phase II study. Clinical Rehabilitation 1998;12:294‐303. - PubMed
Van Heugten 1999
    1. Heugten CM, Dekker J, Deelman BG, Stehmann‐Saris JC, Kinebanian A. A diagnostic test for apraxia in stroke patients: internal consistency and diagnostic value. The Clinical Neuropsychologist 1999;13:182‐92. - PubMed
Wade 1985
    1. Wade D, Skilbeck C, David R, Langton‐Hewer R. Stroke: A critical approach to diagnosis, treatment and management. London: Chapman and Hall, 1985.
West 2005
    1. West C, Hesketh A, Vail A, Bowen A. Interventions for apraxia of speech following stroke. Cochrane Database of Systematic Reviews 2005, Issue 4. [Art. No.: CD004298. DOI: 10.1002/14651858.CD004298] - PMC - PubMed
Westcott 2000
    1. Westcott P. Stroke ‐ questions and answers leaflet. London: The Stroke Association, 2000.
WHO 1978
    1. World Health Organization. Offset Series No. 43, Cerebrovascular disease: a clinical and research classification. Geneva: World Health Organization, 1978.
WHO 1989
    1. World Health Organization. Special report: recommendations on stroke prevention, diagnosis and therapy. Stroke 1989;20:1407‐31. - PubMed
WHO 2001
    1. World Health Organization. International Classification of Function. Geneva: World Health Organization, 2001.
Zelen 1974
    1. Zelen M. The randomization and stratification of patients to clinical trials. Journal of Chronic Diseases 1974;27:365‐75. - PubMed