Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature

@article{Babyar2009ClinicalET,
  title={Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature},
  author={Suzanne R Babyar and Margaret G. E. Peterson and Richard W. Bohannon and Dominic P{\'e}rennou and Michael J. Reding},
  journal={Clinical Rehabilitation},
  year={2009},
  volume={23},
  pages={639 - 650}
}
Objective: To examine the clinimetric properties and clinical applicability of published tools for `quantifying' the degree of lateropulsion or pusher syndrome following stroke. Data sources: Search through electronic databases (MEDLINE, EMBASE, CINAHL, Science Citation Index) with the terms lateropulsion, pushing, pusher syndrome, validity, reliability, internal consistency, responsiveness, sensitivity, specificity, posture and stroke. Databases were searched from their inception to October… Expand
Clinical Outcome Measures for Lateropulsion Poststroke: An Updated Systematic Review
TLDR
The BLS should be implemented as soon as contraversive lateropulsion is suspected to guide frontline clinicians' initial plan of care, allow objective identification of change over time, and facilitate easier investigation of interventional efficacy. Expand
Responsiveness of 2 scales to evaluate lateropulsion or pusher syndrome recovery after stroke.
TLDR
The Burke Lateropulsion Scale (BLS) and Postural Assessment Scale for Stroke (PASS), which measures postural abilities, are responsive scales to monitor progress and recovery during rehabilitation. Expand
Inconsistent classification of pusher behaviour in stroke patients: a direct comparison of the Scale for Contraversive Pushing and the Burke Lateropulsion Scale
TLDR
The Burke Lateropulsion Scale is an appropriate alternative to the widely used Scale for Contraversive Pushing to follow-up patients with pusher behaviour (PB); it might be more sensitive to detect mild pushers behaviour in standing and walking. Expand
A new cutoff score for the Burke Lateropulsion Scale improves validity in the classification of pusher behavior in subactue stroke patients.
TLDR
The results of this study support using a BLS cutoff score of ≥3 instead of ≥2 to diagnose PB for research purposes and intervention planning. Expand
Reliability and Validity of the Four-Point Pusher Score: An Assessment Tool for Measuring Lateropulsion and Pusher Behaviour in Adults after Stroke.
TLDR
The 4PPS is a reliable and valid scale to assess lateropulsion and pusher behaviour in stroke survivors in an in-patient rehabilitation setting. Expand
Therapeutic approaches for pusher syndrome after a stroke: a literature review
TLDR
Several approaches were identified for treating pusher syndrome post-stroke, including robot-assisted gait training (RAGT), galvanic vestibular stimulation (GVS), visual feedback (VF), and physiotherapy with additional components such as relaxation therapy in the prone position and lateral stepping with body weight–supported treadmill training (LS-BWSTT). Expand
INCIDENCE OF PUSHER SYNDROME AMONG POST-STROKE PATIENTS
TLDR
Evaluation of incidence of pusher syndrome among post-storke patients in Poland finds no doubts further research into the role of the therapy in post-stroke rehabilitation is need for establishing the most effective ways of the pusher Syndrome therapy. Expand
Spanish translation and validation of the Scale for Contraversive Pushing to measure pusher behaviour.
TLDR
The Spanish-language version of the Scale for Contraversive Pushing is valid and reliable for measuring pusher behaviour in stroke patients and it is able to evaluate the ongoing changes in patients who have received physical therapy. Expand
Diagnostics of disturbed upright body orientation in pusher behaviour
Objective: To compare the classification of two clinical scales for assessing pusher behaviour in a cohort of stroke patients. Design: Observational case-control study. Setting: Inpatient strokeExpand
Posterior Pusher Syndrome - Case Report
Background. Pusher syndrome is classically described as frequent but little-known disorder of body orientation characterized by a tilt towards the contralesional paretic side and a resistance toExpand
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References

SHOWING 1-10 OF 23 REFERENCES
Pusher syndrome: Reliability, validity and sensitivity to change of a classification instrument
Stroke patients with “pusher syndrome” actively push away from the non-paretic side, leading to postural imbalance. The Clinical Scale for Contraversive Pushing (SCP) is the only known instrumentExpand
Validation of a lateropulsion scale for patients recovering from stroke
TLDR
The Lateropulsion Scale is both a reliable and a valid assessment of lateropulsion following stroke, and shows correlations with Fugl-Meyer balance and FIM mobility subscores. Expand
Instructions for the Clinical Scale for Contraversive Pushing (SCP)
TLDR
The authors selected 26 patients who had a hemiparesis and postural asymmetry and their observed cutoff criterion (all 3 SCP variables >0) in this selected patients group now requires further investigation to avoid false-positive diagnoses in an unselected group of stroke patients. Expand
The Scale for Contraversive Pushing: A Reliability and Validity Study
TLDR
The results provide support for use of the Scale for Contraversive Pushing based on its reliability and validity using a modified cutoff criterion to make a diagnosis of PB. Expand
Scale for Contraversive Pushing: Cutoff Scores for Diagnosing “Pusher Behavior” and Construct Validity
TLDR
The results support the validity of the SCP and suggest the need to choose different SCP cutoff criteria (Crit_2 or Crit_3) according to the aim of the evaluation. Expand
Ipsilateral pushing in stroke: incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study.
TLDR
The existence of a "pusher syndrome" encompassing postural imbalance and hemineglect is believed to aggravate the prognosis of stroke patients and Ipsilateral pushing did not affect functional outcome, but slowed the process of recovery considerably. Expand
Poststroke “Pushing”: Natural History and Relationship to Motor and Functional Recovery
Background and Purpose— Patients with hemiparetic stroke have impaired balance control. Some patients (“pushers”) are resistant to accepting weight on and actively “push” away from the nonpareticExpand
Understanding and treating "pusher syndrome".
TLDR
A new physical therapy approach is suggested for patients with pusher syndrome where the visual control of vertical upright orientation, which is undisturbed in these patients, is the central element of intervention. Expand
Prognosis of contraversive pushing
TLDR
The aim for physiotherapy of patients with contraversive pushing thus is to shorten the period of necessary treatment and enable earlier discharge from residential care. Expand
Leg orientation as a clinical sign for pusher syndrome
TLDR
The observation that patients with acute unilateral vestibular loss showed no alterations of leg posture indicates that disturbed Vestibular afferences alone are not responsible for the disordered leg responses seen in pusher patients. Expand
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