Visual perception and praxis in adults after stroke.

OBJECTIVES The purpose of this study was to examine the performance of persons with right cerebrovascular accident (RCVA) and persons with left cerebrovascular accident (LCVA) on a variety of measures of praxis and visual perception in order to examine the relative contributions of the left and right cerebral hemispheres to praxis and perception. METHODS Forty-five subjects, 15 with RCVA, 15 with LCVA, and 15 without CVA (control subjects), were tested on three tests of praxis-praxic production, gesture comprehension, and gesture discrimination-and selected tests of visual perception, including the Judgement of Line Orientation Test, the Motor Free Visual Perception Test, the Hooper Visual Organization Test, and the Line Bisection Test. RESULTS Subjects in both groups with CVA performed more poorly on all of the tests than did control subjects. The group with LCVA performed most poorly on tests of gesture comprehension and praxis production, whereas the group with RCVA performed most poorly on tests of gesture discrimination and visual perception. CONCLUSION These findings suggest that both the right and left cerebral hemispheres contribute to different aspects of praxis. Elements of visual perception may be related to gesture comprehension, gesture discrimination, and praxis production in adults who have had stroke. These findings have clinical implications regarding instructional style and perceptual and praxic training.