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

Area of Science:

• Neurorehabilitation
• Cognitive Neurology

Background:

• Stroke affecting the left inferior parietal lobule and temporal lobe can cause significant apraxia and impact activities of daily living (ADLs).
• Patients may retain semantic knowledge of object function despite motor execution deficits.

Observation:

• A male patient in his late 70s with cardioembolic stroke-induced left inferior parietal lobule and temporal lobe damage presented with severe gesture execution and action sequencing impairments.
• The patient maintained intact semantic knowledge of tool functions.

Findings:

• A combined intervention of gesture training (using tool-use photographs) and sequencing tasks (using photo/text cards for ADLs) was implemented starting day 13 post-stroke.
• By discharge (day 147), Apraxia Screen of TULIA (AST) scores improved from 0 to 7 (right) and 9 (left), and Functional Independence Measure (FIM) motor scores rose from 65 to 87.
• At long-term follow-up (day 425), AST scores reached 10 bilaterally, with the patient achieving independence in basic ADLs.

Implications:

• This case report highlights the effectiveness of integrating gesture training and sequencing tasks for treating apraxia post-stroke.
• Leveraging preserved semantic knowledge is a valuable strategy in neurorehabilitation for improving functional outcomes.
• The findings suggest that targeted interventions can yield significant functional recovery even with extensive brain damage.