Selection and application of familiar and novel tools in patients with left and right hemispheric stroke: Psychometrics and normative data
Selection and application of familiar and novel tools in patients with left and right hemispheric stroke: Psychometrics and normative data
复制标题
DOI：
10.1016/j.cortex.2017.06.001
复制
发表时间：
2017-09-01
期刊：
影响因子：
3.6
通讯作者：
Randerath, Jennifer
中科院分区：
文献类型：
--
作者：
Buchmann, Ilka;Randerath, Jennifer
通常左脑损伤（LBD）会导致肢体失用症，这是一种影响工具使用的疾病。尽管它对日常生活有影响，但检查工具使用和手势模仿的经典测试很少应用于临床实践。该研究的目的是提出一种诊断方法，这种方法似乎与日常生活中的行为更密切相关，以便在患者出院前使申请人和患者对这种疾病的相关性更加敏感。介绍了两项评估实际工具选择和工具-对象应用的测试：新工具（NTT）和熟悉工具（FTT）测试（DILA-S：肢体失用症诊断工具短版的一部分）。收集健康受试者（N = 82）的规范资料。然后将该测试应用于单侧左脑损伤的脑卒中患者（LBD: N = 33）、右脑损伤对照组（RBD: N = 20）以及年龄和性别匹配的健康对照组（CL: N = 28, CR: N = 18）。测试结果显示出适当的解释信度、内部一致性、并发效度和发散效度。为了检验基于众所周知的肢体失用症左侧偏侧的标准效度，进行了组间比较。正如预期的那样，LBD组显示出工具使用失用症的高患病率（NTT: 36.4%, FTT: 48.5%），范围从轻度到重度损伤，得分低于对照组（CL）。少数RBD患者确实表现出工具使用障碍（NTT: 15%, FTT: 15%）。在组水平上，他们与健康对照组（CR）没有差异。此外，研究还表明，对熟悉工具和新工具的选择和应用可能会选择性地受损。我们的研究结果表明，评估工具选择和工具使用的真实工具使用测试应被视为左脑和右脑损伤患者肢体失用症的标准诊断。(C) 2017年作者。Elsevier Ltd.出版。
Frequently left brain damage (LBD) leads to limb apraxia, a disorder that can affect tool use. Despite its impact on daily life, classical tests examining the pantomime of tool-use and imitation of gestures are seldom applied in clinical practice. The study's aim was to present a diagnostic approach which appears more strongly related to actions in daily life in order to sensitize applicants and patients about the relevance of the disorder before patients are discharged.Two tests were introduced that evaluate actual tool selection and tool-object application: the Novel Tools (NTT) and the Familiar Tools (FTT) Test (parts of the DILA-S: Diagnostic Instrument for Limb Apraxia Short Version). Normative data in healthy subjects (N = 82) was collected. Then the tests were applied in stroke patients with unilateral left brain damage (LBD: N = 33), a control right brain damage group (RBD: N = 20) as well as healthy age and gender matched controls (CL: N = 28, and CR, N = 18).The tests showed appropriate interrater-reliability and internal consistency as well as concurrent and divergent validity. To examine criterion validity based on the well-known left lateralization of limb apraxia, group comparisons were run. As expected, the LBD group demonstrated a high prevalence of tool-use apraxia (NTT: 36.4%, FTT: 48.5%) ranging from mild to severe impairment and scored worse than their control group (CL). A few RBD patients did demonstrate impairments in tool-use (NTT: 15%, FTT: 15%). On a group level they did not differ from their healthy controls (CR). Further, it was demonstrated that the selection and application of familiar and novel tools can be impaired selectively.Our study results suggest that real tool-use tests evaluating tool selection and tool application should be considered for standard diagnosis of limb apraxia in left as well as right brain damaged patients. (C) 2017 The Authors. Published by Elsevier Ltd.