Assess Praxis

Praxis is the ability to perform a motor activity. Apraxia is the inability to perform a voluntary movement in the absence of deficits in motor strength, sensation, or coordination. Dyspraxia is the decreased ability to perform the activity. The patient hears and understands the command but cannot integrate the motor activities that will complete the action. Ask a patient to pour water from the bedside pitcher into a glass and drink the water. A patient with dyspraxia may either drink the water from the pitcher or try to drink from the empty glass. A deep frontal lobe lesion is frequently responsible for this disorder.

Another type of apraxia is constructional apraxia. In this condition, the patient is unable to construct or draw simple designs. The examiner draws a shape and asks the patient to copy it. Alternatively, the patient can be asked to draw the face of a clock. Patients with constructional apraxia often have a lesion in the posterior portion of the parietal lobe.

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