Effects of limb apraxia intervention in patients with stroke: A meta-analysis of randomized controlled trials

  • Author Footnotes
    1 Telephone number: +82-10-8570-1602
    Eun Kyu Ji
    1 Telephone number: +82-10-8570-1602
    Department of Occupational Therapy, St. Vincent's Hospital, The Catholic University, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, Republic of Korea
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  • Author Footnotes
    2 Telephone number: +82-43-229-7982, Fax number: +82-43-229-7980
    Jae Sung Kwon
    Corresponding author.
    2 Telephone number: +82-43-229-7982, Fax number: +82-43-229-7980
    Department of Occupational Therapy, College of Health & Medical Sciences, Cheongju University, 298, Daesung-ro, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea, 28497
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  • Author Footnotes
    1 Telephone number: +82-10-8570-1602
    2 Telephone number: +82-43-229-7982, Fax number: +82-43-229-7980



      Limb apraxia, a complication of stroke, causes difficulties in performing activities of daily living (ADL). To date, there are no studies on the effectiveness of limb apraxia interventions. We conducted a meta-analysis to assess the effectiveness of limb apraxia interventions in reducing its severity and improving ADL.


      We conducted a search of randomized controlled trials (RCTs) related to limb apraxia till December 2021 using the databases of PubMed, Embase, CINAHL, and the Cochrane Library. We measured the outcome variables in the subgroups of total apraxia (TA), ideational apraxia (IA), ideomotor apraxia (IMA), and ADL. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality.


      Five RCTs were selected, and of the 310 participants, 155 were in the experimental and 155 in the control group. A random-effects model was used for the effect size distribution. The limb apraxia intervention methods included gesture and strategy training (three and two studies, respectively). The effect sizes of the outcome variables in the subgroups were small for the TA and IA, with 0.475 (95% confidence interval [CI]: -0.151-1.102; p = 0.137) and 0.289 (95% CI: -0.144-0.722; p = 0.191), respectively. IMA had a medium effect size of 0.731 (95% CI: -0.062-1.525; p = 0.071), not statistically significant, whereas ADL effect size was small and statistically significant, 0.416 (95% CI: 0.159-0.673; p = 0.002).


      Gesture and strategy training had statistically significant effects on ADL as limb apraxia interventions. Therefore, the effectiveness of the apraxia interventions needs to be further evaluated through continuous RCTs.


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