Pusher syndrome: Reliability, validity and sensitivity to change of a classification instrument

@article{Lagerqvist2006PusherSR,
  title={Pusher syndrome: Reliability, validity and sensitivity to change of a classification instrument},
  author={Julia Eriksson Lagerqvist and Elisabeth IB Skargren},
  journal={Advances in Physiotherapy},
  year={2006},
  volume={8},
  pages={154 - 160}
}
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 instrument developed to evaluate the degree of pushing, but its reliability and validity has not been evaluated. A pilot study of the Swedish version showed that the instrument needed modification. The main purpose of this study was to investigate the interrater reliability and validity of the modified SCP. In… Expand
Clinical Assessment Scale for Contraversive Pushing, interrater reliability of a Swedish version
TLDR
The Swedish version of SCP is reliable for assessing pusher syndrome in patients with stroke and may help clinicians to standardize their assessments. Expand
Scale for contraversive pushing in stroke patients: pusher behavior vs Thalamic astasia differential diagnosis and psychometric properties.
TLDR
The SCP is a reliable and valid tool which can successfully establish differential diagnosis between PB and TA and evaluate the changes generated by physiotherapy treatment. 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
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
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
Time Course and Influence of Pusher Behavior on Outcome in a Rehabilitation Setting: A Prospective Cohort Study
TLDR
The prevalence and time course of pusher behavior among patients with hemiparesis in a rehabilitation setting reveal PB as a relevant disorder in stroke rehabilitation, however, the duration of the behavior differed widely among the PB patients. Expand
Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature
TLDR
Validity and reliability data support the clinical use of the Scale for Contraversive Pushing, the Modified Scale for Controversial Pushing and the Burke Lateropulsion Scale, and the other tools show promising preliminary evidence of clinical and research utility. Expand
Síndrome de Pusher em Pacientes com AVC e Sua Associação com Gravidade Clínica e Dependência Funcional
TLDR
The prevalence of PS in patients after acute stroke is significant and can vary according to the criteria used, and its presence is associated with clinical severity and functional dependence, higher incidence in ischemic stroke event, parietal lobe and middle cerebral artery, respectively. 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
New Insights for a Better Understanding of the Pusher Behavior: From Clinical to Neuroimaging Features
TLDR
Patients with postural balance dysfunction in stroke patients report a fear of falling towards their ipsilesional side and strongly resist any attempt at passive correction of their tilted body while sitting or standing, and are not aware that their active pushing is counterproductive and makes it impossible for them to stand without assistance. Expand
...
1
2
...

References

SHOWING 1-10 OF 34 REFERENCES
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
Physiotherapy for pusher behaviour in a patient with post-stroke hemiplegia.
TLDR
A literature-based physiotherapy treatment for a stroke patient with clear pusher behaviour makes the patient able to use compensatory strategies for functional activities and results were not maintained to the end of the treatment period. Expand
Measuring balance in the elderly: preliminary development of an instrument
TLDR
The goal for this study was to develop a measure of balance appropriate for elderly individuals and there was a high degree of internal consistency, a Cronbach's alpha of .96, which indicates the movements reflect a single underlying dimension. 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
Understanding the pusher behavior of some stroke patients with spatial deficits: a pilot study.
TLDR
This pilot kinematic analysis shows that pusher behavior does not result from disrupted processing of vestibular information (eg, caused by a lesion involving the Vestibular cortex), but it results from a high-order disruption in the processing of somesthetic information originating in the left hemibody, which could be graviceptive neglect (extinction). Expand
The origin of contraversive pushing
TLDR
A separate pathway seems to be present in humans for sensing the orientation of gravity apart from the one for orientation perception of the visual world, and this second graviceptive system decisively contributes to humans’ control of upright body posture. Expand
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
The ‘pusher’ syndrome in elderly stroke patients
TLDR
Therapists should identify perceptual as well as physical deficits in stroke patients to enable appropriate management of the ‘pusher’ syndrome. Expand
The neural representation of postural control in humans.
TLDR
The ventral posterior and lateral posterior nuclei of the posterolateral thalamus rather seem to be fundamentally involved in the neural representation of a second graviceptive system in humans decisive for the authors' control of upright body posture. Expand
Posterior thalamic hemorrhage induces “pusher syndrome”
...
1
2
3
4
...