The bodily experience of apraxia in everyday activities: a phenomenological study.
OBJECTIVE
The aim of this study is to explore apraxia as a phenomenon in everyday activities, as experienced by a group of stroke patients. Some consequences for clinical practice are suggested.


METHODS
In this phenomenological hermeneutical study, six persons with apraxia were followed from 2 to 6 months, from the early phase of stroke rehabilitation. ADL-situations and interactions with therapists were observed and videotaped repeatedly during the rehabilitation trajectory, to provide access to and familiarity with the participant's apractic difficulties over time. Two in-depth interviews were conducted with each participant. Interviews and video observations were analyzed together, taking Merleau-Ponty's concept of bodily intentionality as basis for analysis and his phenomenology as the main theoretical perspective of the study.


RESULTS
Five types of altered bodily intentionality were described by the participants [ 1 ]: Gap between intention and bodily action [ 2 ], Fragmented awareness in action [ 3 ], Peculiar actions and odd bodies [ 4 ], Intentionality on the loose, and [ 5 ] Fighting against tools. These were recognized as characteristics typical of the apraxia experience.


CONCLUSIONS
The phenomenology of Merleau-Ponty, and his concept of bodily intentionality in particular, elucidate the way specific apractic difficulties come into being and may thus render apraxia less incomprehensible. The apraxia phenomenon appears as characteristic fragmentations of anticipation inherent in action performance, thereby "slackening" the bodily intentionality. Identifying apractic changes of intentionality may help health professionals to adjust and individualize therapy, and facilitate patients' acting competence in everyday life.
Division of Rehabilitation Services, University Hospital of North Norway, Norway. cathrine.arntzen@unn.no
Cathrine
C
Arntzen
Ingunn
I
Elstad
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001072:Apraxias / Q000209:etiology*; D005500:Follow-Up Studies; D018594:Human Body; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010686:Philosophy, Medical; D011597:Psychomotor Performance; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014743:Videotape Recording