title: Systematic assessment of apraxia and functional predictions from the Birmingham Cognitive Screen.
abstract: OBJECTIVE
  The validity and functional predictive values of the apraxia tests in the Birmingham Cognitive Screen (BCoS) were evaluated. BCoS was developed to identify patients with different forms of praxic deficit using procedures designed to be inclusive for patients with aphasia and/or spatial neglect.
  
  
  METHODS
  Observational studies were conducted from a university neuropsychological assessment centre and from acute and rehabilitation stroke care hospitals throughout an English region. Volunteers from referred patients with chronic acquired brain injuries, a consecutive hospital sample of patients within 3 months of stroke (n=635) and a population based healthy control sample (n=100) were recruited. The main outcome measures used were the Barthel Index, the Nottingham Extended Activities of Daily Living Scale as well as recovery from apraxia.
  
  
  RESULTS
  There were high inter-rater reliabilities and correlations between the BCoS apraxia tasks and counterpart tests from the literature. The vast majority (88.3%) of the stroke survivors were able to complete the screen. Pantomime and gesture recognition tasks were more sensitive in differentiating between individuals with left hemisphere damage and right hemisphere damage whereas the Multistep Object Use test and the imitation task had higher functional correlates over and above effects of hemiplegia. Together, the initial scores of the four tasks enabled predictions with 75% accuracy, the recovery of apraxia and independence level at 9 months.
  
  
  CONCLUSIONS
  As a model based assessment, BCoS offers a quick and valid way to detect apraxia and predict functional recovery. It enables early and informative assessment of most stroke patients for rehabilitation planning.
authors.affiliation: School of Psychology, Hills Building, University of Birmingham, Birmingham, UK. w.bickerton@bham.ac.uk
authors.forename: Wai-Ling
authors.initials: WL
authors.lastname: Bickerton
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Riddoch
authors.forename: Dana
authors.initials: D
authors.lastname: Samson
authors.forename: Alex Bahrami
authors.initials: AB
authors.lastname: Balani
authors.forename: Bejal
authors.initials: B
authors.lastname: Mistry
authors.forename: Glyn W
authors.initials: GW
authors.lastname: Humphreys
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D001072:Apraxias / Q000150:complications / Q000175:diagnosis*; D001930:Brain Injuries / Q000150:complications / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications / Q000523:psychology*