What is Praxis?
Praxis is Latin for doing. It is a broad term, which is a complex, multi-step process involving both a cognitive component and a motor component.
Praxis is a word we use often in the pediatric world, as children need opportunities to develop intentional movement skills through play.
Praxis is the ability to conceive, plan, sequence, and execute motor skills. With many forms of dementia, praxis skills tend to diminish.
Praxis is more than motor planning. It is the ability of the brain to generate options and select the most efficient course of action. It is something that healthy-brain people take for granted.
Praxis in Action
Imagine approaching a set of stairs. The railing is on the right, but you also carry your cane with your right hand. In order to go up the stairs, you will need to use your right hand to grab the railing. Deciding how to do this is quite a process. It is called ideation– the generating of different ideas or ways of solving the problem. You can put the cane in your left hand, hand it to someone, leave it behind, or keep it in your right hand and struggle while trying to hold both the cane and the railing at the same time. As a caregiver, we often rush in to help solve the problem before the person has a chance to weigh out all the options. For someone with dementia, it sometimes takes longer to generate the right the response.
Beyond the idea generating and deciding which course of action to take, is the ability to actually execute the movement. The inability to form the plan and create the proper motor response is called apraxia.
A person with apraxia might freeze just before a movement response is required. They just can’t figure out what movements are required and/or how to actually generate the movement. We see this with the use of common objects all the time- the person might recognize a toothbrush, but hesitate or be unable to perform the appropriate action without a cue from the caregiver.
Unlike children, older adults have well worn patterns of movement that they can rely upon to execute a plan without giving the situation much conscious thought. These habits might serve them well, or actually be a detriment in a different context or when there exists a physical limitation that requires some active problem solving. This is why older adults need plenty of opportunities to fire that prefrontal cortex. They need to flex the praxis muscle and generate movement options and put them to use.
Praxis skills can be strengthened, but it requires practice and repetition in situations where old habits and movement patterns cannot be relied upon. Providing engagement opportunities that are novel or challenging and require a movement response is key- how will they get around that puddle? Over? Around? Through?
Healthy brain adults listen up- this is for you too! Learn new stuff that requires a motor output- take dance lessons, try an indoor rock climbing class, learn a sport. For optimal brain health, don’t just sit at a computer and play brain games- use the brain and body together and strengthen your praxis skills.