Background
Comparing cohorts with similar functional and motor status at admission to inpatient
rehabilitation may delineate demographics or impairments associated with recovery
from lateropulsion, also known as “pusher syndrome,” after stroke based on lesion
side. The aim of this case–control study was to determine how demographics and severity
of stroke impairments at admission to inpatient rehabilitation distinguish patients
who recover from lateropulsion from those who do not.
Methods
Patients with admission motor Functional Independence Measure (FIM) scores less than
31 and contralesional lower extremity Fugl-Meyer motor scores less than 19 out of
34 were included. Burke Lateropulsion Scales score of 2 or higher at the time of discharge
from inpatient rehabilitation indicated persistent lateropulsion; a score of 0 or
1 indicated resolved lateropulsion. Logistic regression tests included age, gender,
admission Motricity Index score, limb placement error, and cognitive FIM score. χ2 analyses compared groups for neglect.
Results
For patients with left brain lesion, older age and worse admission motor status distinguished
those with persistent lateropulsion at discharge. For right brain lesion, related
factors were older age, greater admission limb placement error, and lower cognitive
FIM scores. Visuospatial neglect did not influence recovery from lateropulsion.
Conclusions
Older age and severe impairments were associated with delayed recovery from lateropulsion
in a manner specific to lesion side in a sample with motor and functional deficits.
The study provides evidence that lesion side and admission characteristics are useful
in early decision making for the duration of rehabilitation, selection of interventions,
and discharge planning.
Key Words
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Article info
Publication history
Published online: September 07, 2016
Accepted:
August 16,
2016
Received in revised form:
August 11,
2016
Received:
June 13,
2016
Footnotes
Research site: Stroke Unit, Burke Rehabilitation Hospital, 785 Mamaroneck Avenue, White Plains, New York, USA 10605.
Funding: Partial support for this project was provided by a PSC-CUNY Award, jointly funded by the Professional Staff Congress and the City University of New York (TRADA-42-400).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.08.024
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
