title: The course of apraxia and ADL functioning in left hemisphere stroke patients treated in rehabilitation centres and nursing homes.
abstract: OBJECTIVE
  To study the course of apraxia and daily life functioning (ADL) in left hemisphere stroke patients with apraxia.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Rehabilitation centres and nursing homes.
  
  
  METHODS
  One hundred and eight left hemisphere stroke patients with apraxia, hospitalized in rehabilitation centres and nursing homes.
  
  
  METHODS
  ADL-observations, Barthel ADL Index, Apraxia Test, Motricity Index.
  
  
  RESULTS
  During the study period of 20 weeks, patients showed small improvements in apraxia (standardized mean differences of 0.19 and 0.33) and medium-sized improvements in ADL functioning (standardized mean differences from 0.37 to 0.61). About 88% of the patients were still apraxic at week 20. Less improvement in apraxia was observed in initially less severe apraxic patients. Less improvement in ADL functioning was found to be associated with more severe apraxia, a more independent initial ADL score, higher age, impaired motor functioning and longer time between stroke and first assessment.
  
  
  CONCLUSIONS
  Apraxia in stroke patients is a persistent disorder, which has an adverse influence on ADL recovery.
authors.affiliation: Netherlands Institute of Health Services Research (NIVEL), Utrecht and Department of Rehabilitation Medicine, Erasmus Medical Centre, 3000 CA Rotterdam, the Netherlands. M.Donkervoort@ErasmusMC.nl
authors.forename: Mireille
authors.initials: M
authors.lastname: Donkervoort
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
authors.forename: Betto
authors.initials: B
authors.lastname: Deelman
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001072:Apraxias / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation