Impaired everyday gestural communication in apraxia: A reliable and valid short scale

Abstract

Dear editor,

Gestural communication is important in stroke patients with moderate to severe aphasia to express their needs.¹ The negative impact of apraxia on spontaneous use of gestural communication in left hemispheric stroke (LHS) was suggested previously.^2,3 Rapid and valid assessment of everyday gestural communication is therefore paramount for the care of aphasic stroke patients. The aim of the present study was to evaluate the reliability and validity of a short scale for gestural communication (SGC) in stroke patients.

Sixty left (LHS, n = 30) and right (RHS, n = 30) hemispheric stroke patients in an inpatient rehabilitation setting were included in this study. Spontaneous gestural communication was rated using SGC (see supplementary figure, available online with this letter.) by professional caregivers. Upper limb apraxia was assessed by a standardized apraxia screening of TULIA (AST).⁴ Aphasia was measured by the Token test.⁵

Figure 1.

Scale for Gestural Communication (SGC).

The internal consistency of the total scale of SGC was good (Cronbach’s α = 0.85). At item level, the SGC demonstrated good to excellent interrater reliability. Compared to RHS patients, LHS patients peformed significantly worse on both the AST as well as the SGC (F = 19.99, p < 0.0001, η²= 0.26). Furthermore, a significant correlation was found between the SGC and AST (r = 0.63; p < 0.001) in LHS, which was independent of the severity of aphasia, indicating good criterion validity of the SGC. No correlation (r = 0. 07, p = 0.70) was found between the SGC and AST for RHS patients.

Our findings demonstrate that the SGC is a reliable and valid short scale to assess impaired spontaneous gestural communication in stroke patients with aphasia. The study shows that apraxia impedes everyday gestural communication.

Footnotes

Acknowledgment

We are thankful to Susanne Zürrer for her expertise regarding the development of the SGC.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

References

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. Apraxia, Amsterdam: Elsevier, 2008, pp. 323–338.

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Ziegler

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Goldenberg

. Non-verbal communication in severe aphasia: influence of aphasia, apraxia, or semantic processing? Cortex 2012; 48: 952–962.

Vanbellingen

Kersten

Van de Winckel

. A new bedside test of gestures in stroke: the apraxia screen of TULIA (AST). J Neurol Neurosurg Psychiatry 2011; 82: 389–392.

Lang

CJG

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Leuschner

. Kurze Aphasieprüfung KAP, Frankfurt am Main: Swets Test Services, 1999.

Supplementary Material

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