Apraxia Rehabilitation Using Gesture Training and Sequencing Tasks: A Case Report

This case report describes the effects of combining gesture training and sequencing tasks to improve apraxia and enhance activities of daily living (ADLs) in a patient with left inferior parietal lobule and temporal lobe damage caused by a cardioembolic stroke. The intervention leveraged the patient's preserved semantic knowledge of tools. A male patient in his late 70s presented with significant impairments in gesture execution and action sequencing while retaining semantic knowledge of tool functions. Beginning on day 13 post-onset, the intervention included gesture training with photographs depicting tool use and sequencing tasks using photo and text cards outlining ADL steps. By discharge on day 147, the patient's Apraxia Screen of TULIA (AST) scores improved from 0 bilaterally to 7 on the right and 9 on the left, and the Functional Independence Measure (FIM) motor score increased from 65 to 87. At follow-up on day 425, AST scores further improved to 10 bilaterally, and the patient achieved independence in basic ADLs. This case demonstrates the efficacy of combining gesture training and sequencing tasks in addressing apraxia and improving functional outcomes, even in the presence of extensive damage to the left inferior parietal lobule. The findings underscore the value of leveraging preserved semantic knowledge in rehabilitation.