The course of apraxia and ADL functioning in left hemisphere stroke patients treated in rehabilitation centres and nursing homes

Abstract

Objective: To study the course of apraxia and daily life functioning (ADL) in left hemisphere stroke patients with apraxia. Design: Prospective cohort study. Setting: Rehabilitation centres and nursing homes. Subjects: One hundred and eight left hemisphere stroke patients with apraxia, hospitalized in rehabilitation centres and nursing homes. Measures: ADL-observations, Barthel ADL Index, Apraxia Test, Motricity Index. Results: During the study period of 20 weeks, patients showed small improvements in apraxia (standardized mean differences of 0.19 and 0.33) and medium-sized improvements in ADL functioning (standardized mean differences from 0.37 to 0.61). About 88% of the patients were still apraxic at week 20. Less improvement in apraxia was observed in initially less severe apraxic patients. Less improvement in ADL functioning was found to be associated with more severe apraxia, a more independent initial ADL score, higher age, impaired motor functioning and longer time between stroke and first assessment. Conclusions: Apraxia in stroke patients is a persistent disorder, which has an adverse influence on ADL recovery.