Presence of Ideomotor Apraxia in Stroke Patients with Pusher Syndrome

Kwon, Yong Hyun; Kwon, Jung Won; Park, Sang Young; Lee, Mi Young; Jang, Sung Ho; Kim, Chung Sun

doi:10.1589/jpts.23.635

Cited by 2 publications

(14 citation statements)

References 22 publications

(32 reference statements)

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“…Prawidłowe rozpoznanie zespołu odpychania jest czynnikiem decydującym o skuteczności wdrożonej terapii. Szczególnie istotnym aspektem diagnozy pozostaje rozpoznanie charakterystycznych zachowań pacjenta w różnych pozycjach ciała [8,9,10].…”

Section: Aktualny Stan Wiedzyunclassified

“…Terapeuta usiłujący podtrzymać pacjenta od strony porażonej, w celu zneutralizowania jego postawy lub powstrzymania upadku, odczuje aktywne pchanie -niekiedy z bardzo dużą siłą [8,9,16].…”

Section: Aktualny Stan Wiedzyunclassified

“…Drugim rodzajem ćwiczeń wykonywanych z osobami z zespołem odpychania jest rehabilitacja pacjenta (w pozycji siedzącej bez podparcia) przeprowadzana w pozycji hiperkorekcji -na stronę nieporażoną. W ten sposób dochodzi do przeciwdziałania skłonnościom pacjenta do upadania na stronę porażoną i wzmacniania odruchów odpychających strony sprawnej [8,9,10,14,16].…”

Section: Aktualny Stan Wiedzyunclassified

“…W ten sposób osiągana jest pozycja "pod kątem" -w kierunku strony niesprawnej, a zatem odwrotnie niż odruchowo ustawiłby się pacjent. W celu korygowania pionizacji ciała można chorego ustawiać również prawidłowo -w pionie -w taki sposób, aby przy jego sprawnej stronie znajdowały się punkty o znacznej powierzchni podparcia, ułatwiające korekcję postawy [8,9,10,14,16].…”

Section: Aktualny Stan Wiedzyunclassified

“…Kolejnym etapem pracy przy ścianie może być ustawienie chorego stroną sprawną do powierzchni ściany, ze stopami oddalonymi od niej o około pół metra i z jednoczesnym uniesieniem ręki sprawnej i przyłożeniem jej ściśle do ściany (wraz z dołem pachowym i śródręczem. Szczególną uwagę należy wykazać podczas wdrażania u pacjenta ćwiczeń z obciążeniem -ważne, aby prowadziły one do hiperkorekcji na stronę sprawną -nigdy na porażoną, a także by odbywały się pod kontrolą wzrokową pacjenta (na przykład -przed lustrem) [8,9,10,14,16].…”

Section: Aktualny Stan Wiedzyunclassified

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Pusher syndrome – the role of the Bobath Concept

Miler¹

2015

Med Og Nauk Zdr.

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The Pusher syndrome is described as frequent, but not very well recognized disorder of body posture characterized by a deflection in the opposite direction to the damaged hemisphere, and the active resistance of the patient's external action to restore its true vertical position. The Pusher syndrome occurs more frequently in patients with a history of cerebral vascular event, and was first described by Patricia M. Davies (senior IBITA instructor) in 1985. Bobath Concept Therapy should include not only special exercises, but also the use visual objects as points of reference. The primary objective of rehabilitation is the development of proper mechanism of the righting reflex. The essence of this action is to remove the obstacles blocking the implementation of normal postural and motor patterns, and the provision of correct sensorimotor experiences. This is a long-term process requiring patience and individual therapy tailored to individual patients, depending on motor and cognitive deficits.

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Pusher syndrome – the role of the Bobath Concept

Miler¹

2015

Med Og Nauk Zdr.

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Lateropulsion Prevalence After Stroke

et al. 2022

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Background and Objectives:Lateropulsion is a deficit of active body orientation with respect to gravity in the frontal plane, mostly observed after a stroke. It magnifies mobility limitations and so represents an emerging target in rehabilitation. Efforts to design specific interventional studies require some basic knowledge of epidemiology, which is insufficient today because many studies focused on a few severe forms in individuals called pushers. The objectives of this study were to bridge this gap.Methods:We systematically searched MEDLINE, EMBASE, CINAHL, and Cochrane Clinical Trials up to 31 May 2021 for original research reporting a prevalence or incidence of post-stroke lateropulsion. We followed MOOSE and PRISMA guidelines. Eligibility for inclusion, data extraction, and study quality (Joanna Briggs Institute guidelines) were evaluated by two reviewers who used a standardized protocol: PROSPERO (CRD42020175037). A random-effects meta-analysis was used to obtain the pooled prevalence, whose heterogeneity was investigated by subgroup analysis (stroke locations and post-stroke phases) and meta-regression.Results:We identified 22 studies (5125 individuals; mean age 68.5 years; 42.6% female; assessed 24 days, on average, after stroke), most published after 2000. The studies’ quality was adequate, with only 8 (36.4%) showing risk of bias. The pooled lateropulsion prevalence was 55.1% (95% confidence interval [CI] [35.9–74.2]) and was consistent across assessment tools. After supratentorial stroke, lateropulsion prevalence was 41% (95%CI [33.5–48.5]), and only 12.5% (95%CI [9.2–15.9]) in individuals with severe lateropulsion, called pushers. Meta-regression did not reveal any effect of age, sex, geographic region, publication year, or study quality. Lateropulsion prevalence progressively decreased from 52.8% (95%CI [40.7–65]) in the acute phase to 37% (95%CI [26.3–47.7]) in the early subacute phase and 22.8% (95%CI [0–46.3]) in the late subacute phase. The ratio of right- to left-hemispheric stroke with lateropulsion increased as a function of time: 1.7 in the acute phase to 7.7 in the late subacute phase. After infratentorial stroke, lateropulsion prevalence was very high, reaching 83.2% (95%CI [63.9–100.3]).Conclusions:Post-stroke lateropulsion prevalence is high, which appeals for its systematic detection to guide early interventions. Uprightness is predominantly controlled from the right hemisphere.

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Presence of Ideomotor Apraxia in Stroke Patients with Pusher Syndrome

Cited by 2 publications

References 22 publications

Pusher syndrome – the role of the Bobath Concept

Pusher syndrome – the role of the Bobath Concept

Lateropulsion Prevalence After Stroke

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