Relationship of Constructional Apraxia and Body Scheme Disorders to Dressing Performance in Adult CVA

The relationship between constructional apraxia and body scheme disorders and failure of post-cerebral vascular accident (CVA) patzents to achieve independence In upper extremity dressing was Investigated in thzs study. One hundred and one subjects wzth rightand left-CVA were gwen tests that measured body scheme dysfunction and constructional apraxia on admission to an Inpatzent rehabilitation unit, and then rated on upper extremity dressing performance at discharge. Scores on the apraxza and body scheme tests were statzstically correlated with dressing performance. The results indicated that both constructional apraxia and body scheme dysfunctlOn contrzbute to failure in achieving upper extremity dressing, but that body scheme performance zs a better predictor of dressing ability. In addition, the presence of visual fzeld deficits, medical complications, and aphasl:a were found to exert szgnifzcant influence on subject performance. O ne of the most frustrating problems encountered by therapists who work in stroke rehabilitation is the patient who is unable to achieve independence in basic dressing skills despite intensive training. These patients seem incapable of relearning the basic self-care skills they acquired in childhood. They often dress themselves no better at discharge than they did on admission, although