Post-stroke lateropulsion terminology: pushing for agreement amongst experts

Nolan, Jessica; Jacques, Angela; Godecke, Erin; Abe, Hiroaki; Babyar, Suzanne; Bergmann, Jeannine; Birnbaum, Melissa; Dai, Shenhao; Danells, Cynthia; Edwards, Dylan J.; Gandolfi, Marialuisa; Jahn, Klaus; Koter, Ryan; Mansfield, Avril; Nakamura, Junji; Pardo, Vicky; Pérennou, Dominic; Piscicelli, Céline; Punt, David; Romick-Sheldon, Devra; Saeys, Wim; Smania, Nicola; Vaes, Nathalie; Whitt, Abigail L; Singer, Barbara

doi:10.1016/j.rehab.2022.101684

Cited by 12 publications

(11 citation statements)

References 11 publications

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“…This Delphi Panel Process conformed with the Guidance on Conducting and Reporting Delphi Studies 12 recommendations. The Process was registered via Open Science Framework at https://doi.org/10.17605/OSF.IO/KN3JT 13 and consisted of two sections: The first aiming to provide recommendations regarding terminology, 3 and the second to provide recommendations regarding rehabilitation for post-stroke lateropulsion. This paper addresses recommendations for rehabilitation of lateropulsion.…”

Section: Methodsmentioning

confidence: 99%

“…(Results of this component of the study are published elsewhere. 3 ) Please outline the most important components of the education about lateropulsion, which should be provided to affected people after stroke and their families/carers. Does the management of people with post-stroke lateropulsion vary according to assessment findings and/or presence of additional effects of stroke? Yes/No Please outline the factors that determine management strategies, and the ways in which these factors relate to management of the affected person. Please list the most important elements of rehabilitation for a person with post-stroke lateropulsion. Is the fear of falling an issue in people with post-stroke lateropulsion?…”

Section: Methodsmentioning

confidence: 99%

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Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel

et al. 2023

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Objective People exhibiting post-stroke lateropulsion actively push their body across the midline to the more affected side and/or resist weight shift toward the less affected side. Despite its prevalence and associated negative rehabilitation outcomes, no clinical practice guidelines exist for the rehabilitation of post-stroke lateropulsion. We aimed to develop consensus-based clinical practice recommendations for managing post-stroke lateropulsion using an international expert panel. Design This Delphi panel process conformed with Guidance on Conducting and Reporting Delphi Studies recommendations. Participants Panel members had demonstrated clinical and/or scientific background in the rehabilitation of people with post-stroke lateropulsion. Main Measures The process consisted of four electronic survey rounds. Round One consisted of 13 open questions. Subsequent rounds ascertained levels of agreement with statements derived from Round One. Consensus was defined a priori as ≥75% agreement (agree or strongly agree), or ≥70% agreement after excluding ‘unsure’ responses. Results Twenty participants completed all four rounds. Consensus was achieved regarding a total of 119 recommendations for rehabilitation approaches and considerations for rehabilitation delivery, positioning, managing fear of falling and fatigue, optimal therapy dose, and discharge planning. Statements for which ‘some agreement’ (50%–74% agreement) was achieved and those for which recommendations remain to be clarified were recorded. Conclusions These recommendations build on existing evidence to guide the selection of interventions for post-stroke lateropulsion. Future research is required to elaborate specific rehabilitation strategies, consider the impact of additional cognitive and perceptual impairments, describe positioning options, and detail optimal therapy dose for people with lateropulsion.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel

et al. 2023

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“…3 Individuals with LP push themselves away from their nonparetic body side and/or resist any attempt to transfer weight over to the nonparetic side. [4][5][6] Depending on its severity, LP can be present not only during standing but also during sitting, during postural transitions, or even while lying down. It is assumed that an underlying mechanism of LP is a disturbed internal reference frame for the representation of postural verticality.…”

Section: Introductionmentioning

confidence: 99%

“…Its most frequent etiology is stroke 3. Individuals with LP push themselves away from their nonparetic body side and/or resist any attempt to transfer weight over to the nonparetic side 4–6. Depending on its severity, LP can be present not only during standing but also during sitting, during postural transitions, or even while lying down.…”

Section: Introductionmentioning

confidence: 99%

Lateropulsion in Right-Sided Stroke: Brain Anatomical Correlates of Severity and Duration

López¹,

Krewer²,

Bergmann³

et al. 2023

Journal of Neurologic Physical Therapy

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Background and Purpose: Lateropulsion (LP) is a profound disorder of postural control that has a significant impact on neurorehabilitation. Knowledge of relevant brain areas could guide decisions on appropriate intervention methods. Although LP severity and duration are highly variable in individuals with LP, imaging studies on LP have not sufficiently considered these aspects. The aim of this study was to investigate the lesion location in individuals after stroke and the correlation with LP duration and severity. Methods: A retrospective case-control study using voxel lesion symptom mapping (VLSM) in 74 individuals with right-sided brain lesion (49 with and 25 without LP) was performed to analyze the correlation between lesion location and LP severity. Duration was investigated in a subsample of 22 individuals with LP. LP was diagnosed by means of the Scale for Contraversive Pushing. Results: Individuals with LP showed significantly larger lesion sizes compared with the individuals with no LP. VLSM analysis of LP German Center for Vertigo and Balance Disorders (DSGZ) (E.

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“…21,24,[32][33][34][35][36][37] Spatial neglect encompasses lateropulsion, 11 a postural behavior consisting of a lateral push inducing a body inclination in the coronal plane (whole-body tilt), often associated with resistance to passive correction. [38][39][40] Today, lateropulsion after hemisphere stroke is viewed as an attempt to align the body to a tilted representation of verticality and thus is considered a deficit in body orientation with respect to gravity. 11,24,34,41 In a recent study, Dai et al 11 found that all 62 individuals showing lateropulsion also showed spatial neglect.…”

Section: Introductionmentioning

confidence: 99%

Spatial neglect encompasses impaired verticality representation after right hemisphere stroke

Lafitte

Jeager

Piscicelli

et al. 2022

Annals of the New York Academy of Sciences

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Spatial neglect after right hemisphere stroke (RHS) was recently found to encompass lateropulsion, a deficit in body orientation with respect to gravity caused by altered brain processing of graviception. By analogy, we hypothesized that spatial neglect after RHS might encompass an altered representation of verticality. We also assumed a strong relation between body neglect and impaired postural vertical, both referring to the body. To tackle these issues, we performed contingency and correlation analyses between two domains of spatial neglect (body, extra-body) and two modalities of verticality perception (postural, visual) in 77 individuals (median age = 67) with a first-ever subacute RHS (1-3 months). All individuals with a transmodal (postural and visual) tilt in verticality perception (n = 26) had spatial neglect, but the reverse was not found.Correlation and multivariate analyses revealed that spatial neglect (and notably body neglect) was associated more with postural than visual vertical tilts. These findings indicate that after RHS, an impaired verticality representation results from a kind of graviceptive neglect, bearing first on somaesthetic graviception and second on vestibular graviception. They also suggest that the human brain uses not only a mosaic of 2D representations but also 3D maps involving a transmodal representation of verticality.

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Post-stroke lateropulsion terminology: pushing for agreement amongst experts

Cited by 12 publications

References 11 publications

Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel

Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel

Lateropulsion in Right-Sided Stroke: Brain Anatomical Correlates of Severity and Duration

Spatial neglect encompasses impaired verticality representation after right hemisphere stroke

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