Elsevier

Cortex

Volume 93, August 2017, Page 228
Cortex

Discussion forum
Definition: Limb apraxia

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Definition

Limb apraxia designates the inability to perform skilled and/or learned limb actions on request and/or imitation, independently of sensory-motor impairments and cognitive deficits preventing the understanding of the task or the processing of the stimulus material.

Different forms of limb apraxia exist depending on the task and the nature of the action to be performed. In each form, the deficit is bilateral and involves both limbs, irrespective of the damaged cerebral hemisphere.

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Label

Limb apraxia is the most widely used term. Limb-kinetic apraxia or motor apraxia is characterized by the loss of fine, coordinated finger movements and reflects a primary sensorimotor impairment rather than an apraxic disorder. Labels such as ideomotor (or ideo-kinetic) apraxia and ideational (or conceptual) apraxia are ambiguous as they are used in the literature to refer to the gesture type (e.g., intransitive and transitive, respectively), the task requested (imitation and production on

Acknowledgements

The following authors participated in the open discussion about this definition: R. Cubelli, S. Della Sala, G. Fink, G. Goldenberg.

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    Instead, apraxia is due to impaired performance of specific, skilled, or learned actions (Cubelli, 2017). Apraxia emerges as the inability to (i) imitate gestures, (ii) produce symbolic movements on command, including pantomime of object use, or (iii) actually use objects/tools (Osiurak & Rossetti, 2017). Apraxia can affect different effectors, e.g., the upper limbs (i.e., the arm, hand, and fingers) or the face and mouth (Cubelli, 2017).

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    Apraxia may severely affect both basic activities of daily living (ADL) (i.e., eating, bathing, dressing, toileting, and grooming) (Foundas et al., 1995; Sunderland & Shinner, 2007; Sundet et al., 1988; Vanbellingen & Bohlhalter, 2011), as well as more complex instrumental ADL (iADL) (i.e., communication, meal preparation, shopping) (Bickerton et al., 2012), thereby reducing quality of life (QoL). There is consensus that LA affects three main cognitive-motor domains: gestural imitation, pantomime, and real tool use (Heilman, 2020; Osiurak & Bartolo, 2020; Osiurak & Rossetti, 2017). Gestural imitation and pantomime can be specified in transitive (gesture produced in the presence of an object) and non-transitive (absence of an object) gestures.

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