Buxbaum LJ, Haal KY, Hallett M, Wheaton L, Heilman KM, Rodriguez A, Gonzalez Rothi LJ: Treatment of limb apraxia: moving forward to improved action. Am J Phys Med Rehabil 2008;87:149–161.
Limb apraxia is a common disorder of skilled, purposive movement that is frequently associated with stroke and degenerative diseases such as Alzheimer disease. Despite evidence that several types of limb apraxia significantly impact functional abilities, surprisingly few studies have focused on development of treatment paradigms. Additionally, although the most disabling types of apraxia reflect damage to gesture and/or object memory systems, existing treatments have not fully taken advantage of principles of experience known to affect learning and neural plasticity. We review the current state of the art in the rehabilitation of limb apraxia, indicate possible points of contact with the learning literature, and generate suggestions for how translational principles might be applied to the development of future research on treatment of this disabling disorder.
From the Moss Rehabilitation Research Institute, Philadelphia, Pennsylvania (LJB); Thomas Jefferson University, Philadelphia, Pennsylvania (LJB); Albuquerque Veterans Affairs Medical Center, Albuquerque, New Mexico (KYH); University of New Mexico, Albuquerque, New Mexico (KYH); Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland (MH); Department of Veterans Affairs, Baltimore, Maryland (LW); Baltimore Geriatric Research Education and Clinical Center, Baltimore, Maryland (LW); North Florida/South Georgia Veterans Health System, Gainesville, Florida (KMH, AR, LJG); and University of Florida, Gainesville, Florida (KMH, AR, LJG).
All correspondence and requests for reprints should be addressed to Laurel J. Buxbaum, PsyD, Moss Rehabilitation Research Institute, 1200 West Tabor Rd., Philadelphia, PA 19141.
This paper is an outgrowth of a workshop in plasticity/neurorehabilitation research sponsored and supported by the VA Brain Rehabilitation Research Center of Excellence and the University of Florida Department of Occupational Therapy, Gainesville, Florida. Work on the manuscript was supported in part by NIH R01-NS036387 to Dr. Buxbaum.