Sensitivity of different ADL measures to apraxia and motor impairments.

OBJECTIVE To determine whether specifically designed activities of daily living (ADL) observations can measure disability due to apraxia with more sensitivity than the Barthel ADL Index, a conventional functional scale. DESIGN Cross-sectional study. SETTING Rehabilitation centres and nursing homes. SUBJECTS One hundred and six left hemisphere stroke patients with apraxia, hospitalized in rehabilitation centres and nursing homes. MEASURES ADL observations, Barthel ADL Index, an apraxia test, Motricity Index, Functional Motor Test. RESULTS Multivariate analyses showed that the specific ADL observations were associated with severity of apraxia (and not with motor impairments). The Barthel ADL Index was associated with motor impairments (and not with severity of apraxia). CONCLUSION The assessment of disability in stroke patients with apraxia cannot rely only on the Barthel ADL Index. In addition, the specific ADL observation procedure is needed to measure disability due to apraxia.