2017 Volume 39 Issue 4 Pages 292-298
Apraxia shows various serious effects on the activities of daily living. Although a few reports about apraxia have already been published, establishing rehabilitation methods to solve the effects of apraxia is difficult because of the variety and complexity of the symptoms. We examined the rehabilitation of an 82-year-old woman with ideational, ideomotor, and limb-kinetic apraxia, as well as very mild motor paralysis with moderate sensory disturbance in her right-side extremities due to atherothrombotic brain infarction in the left temporo-parietal lobe. Our focus was on her performance of eating with a spoon and fork using her right hand. During the training, we initially recommended her to use the spoon and fork with her left hand. Consequently, she was asked to use them with her right hand. After repetition of this task without error, she was finally able to eat perfectly with a spoon and fork using her right hand. The mechanism of this improvement may be due to the sensory abilities of her left hand covered with the sensory disturbance of her right hand. Use of the left hand may lead to the recognition of errors, access to manipulation/conceptual knowledge, and initiation of the correct motor program for use of the fork and spoon, resulting in accelerated motor learning and improved the use of the spoon and fork with the right hand.
