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Primary Focus: Rehab, Disability, & Participation

Target Audience: Mixed, OT, OTA

Level: Intermediate

Learning Objectives:

  1. Define post stroke apraxia and the general interventions under the scope of occupational therapy
  2. Recognize and describe best practice interventions for apraxia based on synthesis of available evidence
  3. Discuss application of apraxia interventions in your own practice


Rationale: Stroke affects more than 795,000 people every year in the United States and is a leading cause of long term disability (CDC, 2005). Stroke causes motor, and cognitive deficits that decreases independence in activities of daily living (ADLs) (Kelly-Hayes et al.,2003). Apraxia is common post-stroke with a direct impact upon functional abilities and presents with deficits in movement, gesture representation, and memory (Wu, Burgard, & Radel, 2014). Literature continues to rely on statistics about prevalence of apraxia post-stroke published in the 1980’s (Wu, Burgard, & Radel, 2014). Research regarding etiology, evaluation, and assessment of apraxia appears to be more prevalent than research focusing on interventions. Further research on interventions for apraxia is necessary for optimal client outcomes. Occupational therapy (OT) is in a unique position for analyzing activities and providing strategies to increase independence with ADLs in individual with apraxia and stroke. Problem statement: Research relating to OT interventions and the impact on participation in ADLs is scarce. The purpose of this systematic review was to find evidence supporting OT interventions to increase participation in ADLs in adults post stroke with apraxia. Methods: An exhaustive search was performed using CINAHL, PUBMED, OT Search, and references cited by articles identified as relevant. Articles were screened by all reviewers based on titles, abstracts, and keywords to assess for eligibility using a systematic approach. Inclusion criteria were: published between 1980-July 2014, all study designs with a functional occupation based outcome, and OT interventions with participants that were adults post any type of stroke with symptoms of apraxia. Articles screened were obtained and rated using the Evaluation of Quality of Intervention Study (Law & MacDermid, 2014) for experimental designs and the PRISMA Checklist (Moher, Liberati, Tetzlaff, & Altman, 2009) for systematic reviews. Conclusions: The literature describes multiple interventions for apraxia which are held in high regard in the evidence. There is not a singular intervention that is the best practice for occupational therapists to provide. However, there is strong evidence to support the use of strategy training, gesture training, and individualized OT treatments for carryover of training into daily life. Further higher level research is indicated to determine best practice treatment for apraxia.

Presentation: 39 minutes