Disorders of neural body scheme are common perceptual sequelae following hemiplegia. Such disorders affect performance of voluntary movements and quality of functional performance adversely. This article provides a comprehensive definition of body scheme and explains its development, maintenance and newel basis. It further explains the distortions of body scheme and classifies the syndromes following hemiplegia, with implications for occupational therapy. Based on published evidence, the article discusses the strengths and limitations of various body scheme measurements and concludes with recommendations that, first, further studies are required to establish the validity of existing body scheme assessments and, secondly, there is a need for a study comparing neurologically unimpaired adults with neurologically impaired adults to determine the impact of body scheme on functional performance.
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References
1.
AndersonEKChoyE, (1970) Parietal lobe syndromes in hemiplegia. American Journal of Occupational Therapy, 24, 13–18.
2.
AyresAJ, (1972) Sensory integration and learning disorders. California: Western Psychological Services.
3.
BentonA, (1961) The fiction of the Gerstmann Syndrome. Journal of Neurology. Neurosurgery and Psychiatry, 24, 176–81.
4.
BernspangBAsplundKErikssonSFugl-MeyerA, (1987) Motor and perceptual impairments in acute stroke patients: Effects on self-care ability. Stroke, 18, 1081–86.
5.
BooneDLandesB, (1968) Left/right discrimination in hemiplegic patients. Archives of Physical Medicine and Rehabilitation, 49, 533–37.
6.
CritchleyM, (1953) The parietal lobes. London: Edward Arnold.
7.
CritchleyM, (1966) The enigma of Gerstmann's Syndrome. Brain, 89, 83–98.
8.
CummingWJK, (1988) The neurobiology of the body schema. British Journal of Psychiatry, 153, 7–11.
9.
EdmansJATowleDLincolnNB, (1991) The recovery of perceptual problems after stroke and the impact on daily life. Clinical Rehabilitation, 5, 301–309.
10.
FallCC, (1987) Comparing ways of measuring constructional praxis in the well elderly. American Journal of Occupational Therapy, 41, 500–504.
11.
FeigensonJSPolkowLKeeganN, (1980) Burke perceptual profile. New York: American Neurological Foundation.
12.
FrederiksJAM, (1985) Disorders of the body schema. In: VinkenPBruynG, eds. The handbook of clinical neurology. Amsterdam: Elsevier, 100–43.
13.
FriedmanPJLeongL, (1992) The Rivermead Perceptual Assessment Battery in acute stroke. British Journal of Occupational Therapy, 55, 233–37.
14.
HarloweDVan DeusenJ, (1984) Construct validation of the St Mary's CVA evaluation: Perceptual measures. American Journal of Occupational Therapy, 38, 184–86.
15.
HeilmanKMValensteinEWatsonRT, (1985) The neglect syndrome. In: VinkenPJBruynGW, eds. Handbook of clinical neurology. Amsterdam: Elsevier, 153–85.
16.
HodgesCBenderL, (1994) Phantom pain: A critical review of the proposed mechanisms. British Journal of Occupational Therapy, 57, 209–12.
17.
KingLJ, (1982) The person symbol as an assessment tool. In: HemphillB, ed. The evaluative process in psychiatric occupational therapy. New Jersey: Slack.
18.
LaceyJHBirtchnellSA, (1986) Body image and its disturbances. Journal of Psychosomatic Research, 30, 623–31.
19.
LautenbacherSRoscherSStrianFPirkeKMKriegJC, (1993) Theoretical and empirical considerations on the relationship between body image, body scheme and somatosensation. Journal of Psychosomatic Research, 37, 447–54.
20.
LynchJ, (1980) The functional organisation of the posterior parietal association cortex. Behavioural and Brain Sciences, 3, 485–534.
21.
MacDonaldJC, (1960) An investigation of body scheme in adults with cerebral vascular accidents. American Journal of Occupational Therapy, 14, 75–79.
22.
MaloneyMPayneL, (1969) Validity of the Draw-a-Person Test as a measure of body image. Perceptual and Motor Skills, 29, 119–22.
23.
MattheySDonnellySMHextellDL, (1993) The clinical usefulness of the Rivermead Perceptual Assessment Battery. British Journal of Occupational Therapy, 56, 365–70.
24.
NathansonMBergmanPSGordonGG, (1952) Denial of illness: Its occurrence in one hundred consecutive cases of hemiplegia. Archives of Neurology and Psychiatry, 68, 380–67.
25.
PedrettiLWZoltanB, (1990) Occupational therapy: Practice skills for physical dysfunction. 3rd ed.Baltimore: Mosby.
26.
PenfieldWRasmussenT, (1955) The cerebral cortex of man. New York: MacMillan.
27.
PoeckKOrgassB, (1971) The concept of the body schema: A critical review and some experimental results. Cortex, 7, 254–77.
28.
QuintanaLA, (1989) Cognitive and perceptual evaluation and treatment. In: TromblyC, ed. Occupational therapy for physical dysfunction. Baltimore: Williams and Wilkins.
29.
RobinsonROLippoldTLandR, (1986) Body schema: Does it depend on bodily derived sensations?Developmental Medicine and Child Neurology, 28, 49–52.
30.
SauguetJBentonALHecaenH, (1971) Disturbances of the body schema in relation to language impairment and hemispheric locus of lesion. Journal of Neurology, Neurosurgery and Psychiatry, 34, 496–501.
31.
ShahSCooperBMaasF, (1993) Performance on perceptual tasks by neurologically impaired adults using the dominant right hand. Australian Journal of Occupational Therapy, 40, 165–74.
32.
ShontzF, (1955) Body concept disturbances of patients with hemiplegia. Journal of Clinical Psychology, 11, 293–95.
33.
SnaithP, (1992) Body image disorders. Psychotherapy and Psychosomatics, 58, 119–24.
34.
TaylorM, (1968) Analysis of dysfunction in left hemiplegia following stroke. American Journal of Occupational Therapy, 22, 512–20.
35.
ThompsonSBMorganM, (1990) Occupational therapy for stroke rehabilitation. London: Chapman and Hall.
36.
TitusMNGallNGYerxaEJRobersonTAMackW, (1990) Correlation of perceptual performance and activities of daily living in stroke patients. American Journal of Occupational Therapy, 45, 410–18.
37.
TrimbleM, (1988) Body image and the temporal lobes. British Journal of Psychiatry, 153, 12–14.
38.
Van DeusenJFoxHHarloweD, (1984) Construct validation of occupational therapy measures used in CVA evaluation: A beginning. American Journal of Occupational Therapy, 38, 101–106.
39.
Van DeusenJ, (1993) Body image and perceptual dysfunction in adults. Philadelphia: Saunders.
40.
WarrenM, (1981) Factors influencing dressing performance following stroke. American Journal of Occupational Therapy, 36, 34–40.
41.
WarrenM, (1992) A hierarchical model for evaluation and treatment of visual perceptual dysfunction in adult acquired brain injury, part 2. American Journal of Occupational Therapy, 47, 55–62.
42.
WhitingSLincolnNBhavnaniGCockburnJ, (1985) The Rivermead Perceptual Assessment Battery. Windsor: NFER-Nelson.
43.
ZoltanBJabriJRyckmanDLMPanikoffLB, (1983) Perceptual motor evaluation for head injured and other neurologically impaired adults. California: Occupational Therapy Department, Santa Clara Valley Medical Centre.
44.
ZoltanBSievEFreishtatB, (1990) The adult stroke patient: A manual for evaluation and treatment of perceptual and cognitive dysfunction. New York: McGraw Hill.
