An occupational therapy for a case with cerebral infraction who could be reinstated in his former office because of a decrease in his apraxia Yuriko Kiriyama 1,2,3 , Nobuyuki Sunahara 1,4 , Hisao Nishijo 2,3 1Toyama Prefecture Koshi Rehabilitation Hospital 2System Emotional Science,Graduate School of Medicine,Toyama Medical and Pharmaceutical University 3Core Research for Evolutional Science and Technology,Japan Science and Technology Agency 4Former place; Graduate School of Medical Science, Kanazawa University Keyword: 失行 , 体性感覚 , (行為意味システム) , Apraxia , Somatosensory , Action semantic system pp.48-59
Published Date 2006/2/15
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 We report a case of a 41-year old man who exhibited apraxia following left middle cerebral artery domain infraction, and was reinstated in his former office through an occupational therapy.

 He displayed no conspicuous motor function disorder and was independent in his daily activity. However, in his habitual movements and tool use, he made some errors, which were classified as clumsy, parapraxis, etc.

 We applied a vision and object input pathway to the action semantic system, which was suggested in a model of praxis processing by Rothi, to the therapy of the patient. With his hands, he repeated training in the movement of the same tools and objects. At first, he trained with basic tools. And he gradually trained similarly in his job. In this therapeutic approach, a therapist guided the patient's hand with his own hand to execute movements correctly. Eventually he returned to work because the level of his apraxia was decreased.

 In this therapeutic approach, somatosensory cortices and the action semantic system were activated, and the level of his apraxia decreased. However, the disturbance in the patient's conceptual system of the action had remained in his praxis processing after he was reinstated in his former office.

 Therefore, necessity of long-term help was indicated.

Copyright © 2006, Japanese Association of Occupational Therapists. All rights reserved.


電子版ISSN 印刷版ISSN 0289-4920 日本作業療法士協会