Apraxia After Traumatic Brain Injury: What You Need to Know

A traumatic brain injury or TBI is an injury to the brain that happens suddenly. It is typically the result of a direct blow or violent jolt to the head during sports accidents, car crashes, or physical assaults.

The term traumatic brain injury is also an umbrella term pertaining to the various injuries that occur in the brain. Its symptoms can range from mild headaches and concussions to permanent disabilities, coma, or even death. 

The effects of a TBI can vary from person to person. Additionally, it can manifest in different forms, such as physical, cognitive, and behavioral symptoms. One example of a debilitating and life-altering effect of a brain injury is apraxia.

If you or someone you love has been living with apraxia after a TBI, then don’t lose hope. Many therapies and rehabilitative services can improve this condition and offer you a shot at a quality life. Head on below to learn more.

What is apraxia?

Apraxia is a neurological condition wherein a person loses the ability to properly perform skilled actions or learned movements, despite having the willingness to do the command. 

People with apraxia can understand the command and have the desire to perform the task, but are unable to complete the movement due to damage in the cerebral hemisphere of the brain. 

As a result, people with apraxia can experience significant difficulties in doing everyday actions, such as tying shoelaces, eating, or buttoning a shirt.

What are the different types of apraxia?

According to studies, apraxia can come in many types and forms, depending on the body part affected. This includes the following:

Limb kinetic apraxia

The inability to perform precise, coordinated, yet independent movements with the distal limbs, such as the arms, fingers, and legs. For example, being unable to manipulate a scissor or hammer a nail. Even if the person knows what to do or how to use a tool, they won’t be able to accomplish the act due to limb kinetic apraxia.

Ideomotor apraxia

The impaired ability to perform or mimic a limb or head movement when prompted or commanded. However, a person can achieve the same act without prompt, like a reflex action. For example, a patient won’t be able to stand up if asked to, but when told to “turn off the lights”, they will stand up and do the task.

Ideational apraxia

This is the inability to do activities with multiple steps or sequential movements. Often patients with ideational apraxia cannot perform the task because they either cannot formulate the motor movements required or understand the whole concept of the given task.

Sometimes, patients can do independent components of the activity but cannot coherently combine them all to accomplish the whole act.

Conceptual apraxia

In conceptual apraxia, the person cannot do the act because they don’t understand the concept of the object and the supposed matching action. For example, if given a toothbrush and toothpaste, the patient may put the tube in the mouth or use the toothbrush as a comb.

Buccofacial apraxia

The impaired ability to perform movements involving facial muscles of the mouth. Additionally, they are also unable to coordinate facial and lip movements. 

Oculomotor apraxia

The inability to perform voluntary eye movements on command, such as winking. They can freely move their eyes from left to right, but when asked to focus their gaze on an object, they will experience difficulties. 

Verbal apraxia

People with verbal apraxia are unable to coordinate their mouth and speech movements. They may also experience extreme difficulties in the articulation of certain words. 


Some other rare types of apraxia include constructional apraxia, developmental, pantomime agnosia, conduction, tactile, and optical apraxia. 

What are the symptoms of apraxia?

In general, patients with apraxia can understand and have no physical impairments preventing them from performing the task, but cannot do so due to a brain injury. If they try to perform the act, movements may seem clumsy, uncoordinated, or uncontrolled.

Sometimes, people with apraxia may also acquire aphasia or the inability to comprehend or use words. 

Why does it happen after TBI?

The brain consists of lobes and cortexes that work together to achieve motor control and coordination. These parts are also responsible for storing memories of learned movements and actions. 

So when damaged, the nerve cells in these parts can become disrupted and defective, thus impairing the pathways that connect the lobes to other parts of the body. Specifically, apraxia secondary to a TBI injury occurs when there’s a lesion in the following areas of the brain:

  • Premotor frontal cortex of either hemisphere
  • Left inferior parietal lobe
  • Corpus callosum

Besides TBI, other neurological conditions can also cause apraxia, such as dementia, hydrocephalus, stroke, brain tumor, and Parkinson’s disease.

What are the treatment options for apraxia after brain injury?

Doctors can diagnose apraxia by doing a complete medical evaluation and symptom correlation. They will also perform physical examinations and standardized tests, such as:

  • Prompting patients to perform specific tasks, such as activities of daily living, hand gestures, and finger gestures.
  • Other types of neuropsychologic testing to assess brain function.
  • CT scan and MRI to know the root cause of the apraxia.
  • EEG or electroencephalograph
  • Spinal tap to check for possible brain infection and inflammation.

Once diagnosed, treatment efforts will focus on the root condition causing the apraxia, such as TBI. As such, treatment plans will definitely include the following: 

Physical therapy

Physiotherapy plays a major role in improving the symptoms of traumatic brain injury, especially apraxia. It will help strengthen your whole body as you relearn how to perform certain tasks and complex activities. Your treatment may include the following:

  • Strengthening exercises to improve muscle and bone strength.
  • Guided exercises to enhance balance, flexibility, and coordination.
  • Activities that will strengthen fine motor skills.
  • Advice on using assistive devices, such as a walker, cane, or wheelchair.

Repetition of these exercises can also help stimulate neuroplasticity or the ability of the neural network to reorganize and rewire itself and form new communication pathways.

Occupational therapy

Occupational therapy will focus on training the body to perform activities of daily living. This involves learning new strategies to overcome specific activity difficulties and rehearsing functional movements. 

Furthermore, your therapist will teach you new ways to perform a task efficiently without injuring yourself. They will help you break down complex tasks and focus on mastering independent activities first to establish patterns and strengthen these new neural pathways through repetition.

Speech therapy

Treatment of patients with aphasia or verbal apraxia will primarily involve speech-language therapy. Sessions will focus mainly on improving your control and coordination of the facial muscles. Once you relearn how to move these muscles correctly, treatment will focus on enhancing the articulation of syllables, words, and phrases.

neuro rehabilitation

Where to find a traumatic brain injury rehabilitation facility?

Rehabilitation us essential to improving apraxia and its prognosis. With the right social support and a team of esteemed therapists, patients can experience a significant improvement in their quality of life. 

At NeuLife, we strive hard to provide maximum independence and functionality to enhance the patient’s quality of life. Our neuro rehabilitation facility specializes in providing extensive care and 24/7 support to patients with TBI. We also offer other services, such as stroke patient rehab, post acute rehab, and more!

Contact us now at 800-626-3876.


The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.


Dedicated to providing the highest caliber of care to individuals with brain injuries, NeuLife Rehabilitation is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF).
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