Apraxia is
difficulty and failure to properly perform propositional learned movements (praxis) as a result of brain injury and disorders in the absence of elementary sensory motor, perceptual disturbances or comprehension of language. This is reflected in the difficulty to produce gestures and learned previously.
What we mean by gesture, the movements that express some kind of communication that are usually given in a situation where the language used. These gestures can be classified as:
a) Transitive order: are those performed on the body or the external world and involve the use of objects or tools (comb, use a hammer and nail, light a match, etc..).
b) Transitive without object: are gestures of tool use, but made without the object. They also called pantomimes, a clear example of this is to simulate everyday things.
c) Intransitive: are symbolic gestures that do not require any object (such as venetian blind, shake hands, make the leave, etc.)..
conduct a systematic evaluation of apraxia requires:
a) identify their presence.
b) Sort the nature of praxis deficit as mistakes made by the patient.
c) From these data the technique underlying deficit in view of the model.
Liepmann (1900) was the first to formally investigate the apraxia and propose an explanatory model, these contributions are used today, in this sense, the author explains three clinical:
- Apraxia Ideational is the result of the loss of the formulas of the movement (the patient loses the idea of \u200b\u200bmotion.) There is a disorder of the action plan ideational and is manifested by the failure of the use of objects when it should be a complex sequence of events. Patients with this condition have difficulty in performing gestures and non-object transitive and intransitive for both verbal command and to imitation.
- ideomotor apraxia: is due to the disconnect between these formulas and patterns inervatorios (unable to translate the whole idea of \u200b\u200bmoving into a motor program required). There are basically two types of ideomotor apraxia (right-handed subjects):
- For left-brain injury: in these cases, the subjects know what to do, but can not implement it, but when the object is present is given the task can execute (good performance of transitive gestures in order .)
- For lesion of the corpus callosum: Subjects were characterized by good execution with the right arm to order, to imitation and objects, bad execution member upper left to order, using objects well and generally has good imitation. Is due to a shortfall in the transfer interhemispheric.
- mielocinetica Apraxia: is due to the loss of inervatorios patterns (interferes with the selection of muscle synergies necessary to perform the movement). The speed, skill and delicacy of movement are affected regardless of the degree of complexity and automation of the gestures involved. The involvement of members is unilateral and contralateral to the lesion which lies in the promoter region. Patients with this disorder have difficulty performing serial movement, coordinated sequences (eg fist striking the table with singing and with the palm of your hand on), can perform isolated movements, unable to coordinate them in series.
For the evaluation of these cases, some of the ams neuropsychological tests used are:
- The Boston Test (Goodglass and Kaplan, 1963 )
- cognitive assessment of apraxia (Heilman and Gonzalez Rothi Ochipa, 1991. 1997)
- SKA Battery (1996, 1997). "Evaluate the recognition of gestures and gestural production. "
- Battery Florida (Gonzalez Rothi et al., 1992, 1997)
BIBLIOGRAPHY:
. Burin, D., Drake, M. & Harris, P. (2008). "Neuropsychological Assessment in adults." Editorial Paidós. Buenos Aires: Argentina.
. Gonzalez-Rothi, L., Raymer, A. & Heilman, K. (1997). "Limb praxis assessment". London, Psychology Press.
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