Treatment approaches for pusher behaviour: a scoping review

Paci, Matteo; Macchioni, Gabriele; Ferrarello, Francesco

doi:10.1080/10749357.2021.2016098

Cited by 4 publications

(10 citation statements)

References 77 publications

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“…11 The authors reported 'promising results' in studies investigating somatosensory cues and visual-somatosensory integration, while approaches based on visual feedback alone were less effective. 11 They suggested further research to investigate the value of non-invasive brain stimulation (NIBS) in influencing lateropulsion. 11 This study examined consensus among an international Delphi panel of experts tasked with developing clinical practice recommendations for managing lateropulsion after stroke, using resources that are readily available in the majority of clinical settings.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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

et al. 2023

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“…Various interventions for PS have been reported in the literature but their efficacy remains uncertain 6. The majority of the existing studies prevalently based on observational reports show that the intervention focusing on conscious visual feedback is beneficial for patients with PS 7–11.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of the existing studies prevalently based on observational reports show that the intervention focusing on conscious visual feedback is beneficial for patients with PS 7–11. Hypothesising that PS results from a mismatch between the visual and postural perception of the vertical, the use of visual feedback might be considered as a compensatory approach 6 11. Furthermore, these trainings are applied as conscious strategies that would be inefficient for postural control, which normally works under automatic unconscious feedback system.…”

Section: Introductionmentioning

confidence: 99%

“…Various interventions for PS have been reported in the literature but their efficacy remains uncertain. 6 The majority of the existing studies prevalently based on observational reports show that the intervention focusing on conscious visual feedback is beneficial for patients with PS. [7][8][9][10][11] Hypothesising that PS results from a mismatch between the visual and postural perception of the vertical, the use of visual feedback might be considered as a compensatory approach.…”

Section: Introductionmentioning

confidence: 99%

“… 7–11 Hypothesising that PS results from a mismatch between the visual and postural perception of the vertical, the use of visual feedback might be considered as a compensatory approach. 6 11 Furthermore, these trainings are applied as conscious strategies that would be inefficient for postural control, which normally works under automatic unconscious feedback system. Within controlled trials, robotic or machine-assisted somatosensory cues training showed better outcomes than the visual feedback ones 12–14 or general postural training.…”

Section: Introductionmentioning

confidence: 99%

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rTMS for poststroke pusher syndrome: study protocol for a randomised, patient-blinded controlled clinical trial

Meng

Tsang²,

et al. 2022

BMJ Open

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IntroductionPoststroke pusher syndrome (PS) prevalence is high. Patients with PS require longer rehabilitation with prolonged length of stay. Effective treatment of PS remains a challenge for rehabilitation professionals. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that is effective and recommended in the clinical guidelines of stroke rehabilitation. However, the role of rTMS for PS has not been examined. The study is to assess the efficacy of a specific rTMS programme for patients with PS in reducing pushing behaviour, enhancing motor recovery and improving mobility, as well as testing the safety of rTMS for patients with PS.Methods and analysisA randomised, patient and assessor blinded sham-controlled trial with two parallel groups will be conducted. Thirty-four eligible patients with PS will be randomly allocated to receive either rTMS or sham rTMS for 3 weeks. The primary assessment outcome is the pushing behaviour measured by the Burke Lateropulsion Scale and Scale for Contraversive Pushing. The secondary outcomes are the motor functions and mobility measured by the Fugl-Meyer Assessment Scale (motor domain) and Modified Rivermead Mobility Index, and any adverse events. Assessment will be performed at baseline and 1 week, 2 weeks and 3 weeks after intervention. Repeated-measures analysis of variance will be used for data analysis with the level of significance level set at 0.05.Ethics and disseminationThe protocol has been approved by the Biomedical Ethics Committee of West China Hospital, Sichuan University on 23 March 2022 (2022-133). The trial findings will be published in peer-reviewed journals.Trial registration numberChinese Clinical Trial Registry (ChiCTR2200058015).

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The association between neuroimaging data and presence of lateropulsion after stroke

Nolan,

Bynevelt,

Godecke

et al. 2024

Topics in Stroke Rehabilitation

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Treatment approaches for pusher behaviour: a scoping review

Cited by 4 publications

References 77 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

rTMS for poststroke pusher syndrome: study protocol for a randomised, patient-blinded controlled clinical trial

The association between neuroimaging data and presence of lateropulsion after stroke

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