Short apraxia screening test

Abstract

Background: Limb apraxia comprises many different and common disorders, which are largely unrecognized essentially because there is no easy-to-use screening test sensitive enough to identify all types of limb praxis deficits. Method: We evaluated 70 right-handed patients with limb apraxia due to a single focal lesion of the left hemisphere and 40 normal controls, using a new apraxia screening test. The test covered 12 items including: intransitive gestures, transitive gestures elicited under verbal, visual, and tactile modalities, imitation of meaningful and meaningless postures and movements, and a multiple object test. Results: Interrater reliability was maximum for a cutoff of >2 positive items identifying apraxia on the short battery (Cohen’s kappa .918, p < .0001), and somewhat less for >3 items (Cohen’s kappa .768, p < .0001). Although both results were statistically significant, >2 was higher, indicating greater apraxia diagnosis agreement between raters at this cutoff value. Conclusions: The screening test proved to have high specificity and sensitivity to diagnose every type of upper limb praxis deficit, thus showing advantages over previously published tests.

Keywords:

• Apraxia evaluation
• Screening test
• Specificity
• Sensitivity

This article is the final and definitive version of our work. We authorize Taylor & Francis to host our manuscript, and we assign the copyright including abstract, text, bibliography, and all accompanying tables, illustrations, data, and video. Also authors do not have any potential conflict of interest in the publication of the manuscript. The Short Apraxia Screening Test (SAST) we have validated is a modification of a battery outlined during the International Workshop on Ideomotor Apraxia, held in Bethesda, Maryland, on September 2004, sponsored by the Office of Rare Diseases and the National Institute of Neurological Disorders and Stroke at the National Institutes of Health, and by the Movement Disorder Society. The authors thank the following individuals for their participation and contribution in the elaboration of the battery: Richard Andersen, Stephan Bohlhalter, Laurel Buxbaum, Leonardo Cohen, Jose L. Contreras-Vidal, Hans Joachim Freund, Scott Grafton, Leslie J. G. Rothi, Michael Graziano, Kathleen Haaland, Brenda Hanna-Pladdy, Edward B. Healton, Kenneth Heilman, Anthony E. Lang, Jay P. Mohr, Hiroshi Shibasaki, Angela Sirigu, Alan Sunderland, Ivan Toni, Louis Wheaton, and Steven Wise.