Das revidierte Kölner Apraxie-Screening (KAS-R) als diagnostisches Verfahren für Patienten mit rechtshemisphärischem Schlaganfall

Zusammenfassung

Das Kölner Apraxie-Screening (KAS) erfasst apraktische Defizite nach linkshemisphärischen Schlaganfällen. Ziel dieser Studie ist es, durch Anpassungen des Testmaterials des KAS und psychometrische Analysen ein diagnostisches Verfahren für Patienten mit rechtshemisphärischem Schlaganfall zu entwickeln. Mittels Itemanalysen von Daten 77 gesunder Probanden und 100 rechtshemisphärischer Schlaganfallpatienten wurden 8 KAS-Items ausgeschlossen. Das somit noch aus 12 Items bestehende KAS-R weist eine gute interne Konsistenz (α = 0,795) sowie eine hohe Sensitivität (79,4 %) und Spezifität (84,4 %) auf. Bei einem Cut-off-Wert von ≤ 46 (von 48) Punkten zeigen 39 der 100 Schlaganfallpatienten eine Apraxie. Dabei korreliert das KAS-R – im Sinne einer guten Konstruktvalidität – signifikant mit den externen Validierungsverfahren. Die Ergebnisse zeigen, dass das KAS-R ein reliables und valides diagnostisches Verfahren für apraktische Defizite nach rechtshemisphärischem Schlaganfall ist.

Abstract

The Cologne Apraxia Screening (KAS) was developed to diagnose apraxia following left-hemisphere (LH) stroke. The present study aims at developing a diagnostic tool for patients with right-hemisphere (RH) stroke (KAS-R) by modifying the test material of the KAS and reducing the test items based on psychometric analyses.

A total of 100 patients with RH stroke and 77 healthy control participants were tested. Psychometric analyses led to the exclusion of 8 KAS items. The final KAS-R, consisting of 12 items, shows good internal consistency (α = 0.795) as well as high sensitivity (79.4 %) and specificity (84.4 %). Applying a cut-off value of ≤ 46 (out of 48) points, 39 RH stroke patients were diagnosed with apraxia. Significant correlations were found between the KAS-R and an imitation test as well as expert ratings, indicating high construct validity. The results suggest that the KAS-R is a reliable and valid diagnostic tool for apraxic deficits after RH stroke.

Schlüsselwörter

Apraxie - Aphasie - Schlaganfall - Kölner Apraxie-Screening

Key words

apraxia - aphasia - stroke - Cologne apraxia screening

^* Beide Autoren trugen gleichermaßen zum Manuskript bei und teilen sich somit die Erstautorenschaft.

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