@misc{10481/109326,
year = {2025},
month = {2},
url = {https://hdl.handle.net/10481/109326},
abstract = {Objective: To evaluate the reliability, identify the optimal cut-off points, and determine the diagnostic
accuracy of the TULIA Apraxia test in a sample of Spanish-speaking post-stroke patients.
Design: Cross-sectional.
Setting: Public primary care.
Participants: 201 post-stroke patients.
Main Measures: Reliability was assessed using Cronbach’s alpha. Cut-off points were identified for each
TULIA Apraxia sub-test and stratified for age (≤65 years, > 65 years) using ROC curve analysis, area under
the curve, and Youden index. Diagnostic accuracy was evaluated using sensitivity, specificity, and predictive
values.
Results: Cronbach’s alpha of the sub-tests varied from 0.716 (95% CI 0.653–0.772) for pantomime
intransitive to 0.824 (95% CI 0.784–0.858) for imitation non-symbolic. Cut-off points ranged from ≤25
to ≤35 points. For individuals aged ≤65 years, the cut-offs that best balanced sensitivity and specificity
were ≤25 points for detecting alterations in imitation transitive and ≤33 points for pantomime non-symbolic. For individuals over 65 years, the imitation transitive cut-off (≤26 points) presented the most
adjusted balance. The minimum positive predictive value was 0.667 (95% CI 0.542–0.777), indicating
that the TULIA Apraxia tests correctly classified more than 67% of patients with apraxia. The minimum
negative predictive value was 0.763 (95% CI 0.644–0.859), showing that the test accurately identified
more than 76% of patients without apraxia.
Conclusions: The TULIA Apraxia test is reliable in Spanish-speaking post-stroke patients. Optimal cut-off
points, along with their respective sensitivity and specificity values, exhibit adequate test accuracy.
Predictive values indicate that the test correctly identifies individuals with and without apraxia.},
organization = {Junta de Andalucía, FPS 2020, AP-0325-2022},
publisher = {Sage Journals},
keywords = {Apraxia},
keywords = {Stroke},
keywords = {Psychometrics},
title = {Reliability and Optimal Cut-Off Points of the Test for Upper Limb Apraxia (TULIA) for Spanish Speaking Post-Stroke Patients},
doi = {10.1177/02692155241305250},
author = {Sánchez Bermejo, Laura and Milla Ortega, Pedro Jesús and Pérez Mármol, José Manuel},
}