Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Measurement; Brain Injury
Objective : Apraxia is a common cognitive motor deficit that can occur after a stroke but there is no standardized apraxia test for Korean stroke patients. We developed and standardized the Limb and Oral Apraxia Test (LOAT) for Korean patients and investigated its reliability, validity, and clinical usefulness for stroke patients.
Design : Criterion standard for new diagnostic test development
Setting : Tertiary University Medical Center
Participants (or Animals, Specimens, Cadavers) : 324 healthy population and 80 stroke patients
Interventions : We developed the LOAT according to cognitive neuropsychological model of limb and oral praxes. The test included meaningless, intransitive, transitive and oral praxis composed of 72 items (56 items on limb praxis and 16 items on oral praxis, maximum score=216). We standardized the LOAT in a nationwide sample of 324 healthy adults. Intra-rater and inter-rater reliability and concurrent validity tests were performed with stroke patients. We prospectively applied the LOAT for 80 stroke patients and analyzed incidence of apraxia, comparing clinical characteristics between apraxia and non-apraxia groups.
Main Outcome Measure(s) : Internal consistency, reliability test (inter-and intra-rater reliability) and validity test
Internal consistency was high (Cronbach's alpha 0.952). Inter-and intra-rater reliability and concurrent validity were also high; r= 0.924-0.992, 0.961-0.999, 0.830, respectively (pp>0.05). Among the 80 stroke patients, 19 (23.8%) had limb apraxia and 21 (26.3%) had oral apraxia. Left hemispheric lesion and aphasia were significantly higher in the limb or oral apraxia group compared with the non-apraxia group (p<0.001).
Conclusions : The LOAT is a newly developed comprehensive limb and oral apraxia test for Korean stroke patients. It has high internal consistency, reliability, and validity and is a useful apraxia test for stroke patients (This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT)(No. 2019R1A2C2003020).
Jun Soo Noh– Resident, Korea University Anam Hospital, Seoul, Seoul-t'ukpyolsi
Yumi Hwang– Research Professor, Brain Convergence Research Center, Seoul, Seoul-t'ukpyolsi
Ji-Wan Ha– Professor, Daegu University, Gyeongsan, Kyongsang-bukto
Sung Bom Pyun– Professor, Korea University College of Medicine, Seoul, Seoul-t'ukpyolsi