Therapeutic approaches for pusher syndrome after a stroke: a literature review

Thanaya, Sayu Aryantari Putri; Mardhika, Putu Eka

doi:10.15562/ism.v10i2.507

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…Symptoms associated with PS have a significant impact on the daily functioning of the patient and on the effects of therapy, therefore, the earliest possible diagnosis and properly selected targeted treatment has a significant influence on treatment progress. Failure to diagnose the syndrome or incorrect therapy may delay the rehabilitation process by 3 weeks, and even up to 2-3 months [1,7,12,13,15,16,17]. The extension of the rehabilitation period in patients with PS takes place regardless of the damaged hemisphere and gender; however, age and additional disorwww.fizjoterapiapolska.pl ders (e.g.…”

Section: Characteristics and Epidemiology Of Pusher Syndromementioning

confidence: 99%

“…Studies conducted on patients with PS show effectiveness of appropriately conducted therapy. Conventional methods are used, which may be supported by other techniques and orthopaedic devices used in neurorehabilitation [16,28].…”

Section: Possibilities Of Using Physiotherapy In Patients With Pusher...mentioning

confidence: 99%

“…In addition to standard physiotherapy, there are more and more attempts to use complementary methods of therapy for people with PS in order to accelerate and increase treatment effects. Studies show effectiveness of the use of Robotassisted Gait Training (RAGT) robots to assist walking, standers, Visual Feedback (VF) and Virtual Reality (VR) [16,28]. One of the possibilities of supporting therapy of patients with PS is the use of a stander.…”

Section: Possibilities Of Using Physiotherapy In Patients With Pusher...mentioning

confidence: 99%

“…In patients with PS, attempts are also made to use physical therapy treatments. Transcranial Magnetic Stimulation (TMS) and Galvanic Vestibular Stimulation (GVS) are used [16,28]. PS patients were treated with Repetitive Transcranial Magnetic Stimulation (rTMS), which is used in stroke patients.…”

Section: Possibilities Of Using Physiotherapy In Patients With Pusher...mentioning

confidence: 99%

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Possibilities of physiotherapeutic treatment in the case of patients with pusher syndrome

Drozd,

Nowacka-Kłos,

Hansdorfer-Korzon

2023

Fiz Pol

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The consequences of damage to brain structures often includes various types of perceptual and motor disorders. One of them is Pusher Syndrome (PS). It is defined as a disturbance in the perception of the body position in the frontal plane, which in turn makes it difficult to maintain a correct vertical posture. It occurs most often in patients after a stroke of the right hemisphere of the brain, in the posterolateral region of the thalamus, and its frequency is estimated at about 9–50%. However, it is still a little-known syndrome and too rarely diagnosed. Correct, early diagnosis of pusher syndrome and the introduction of appropriate physiotherapy allows us to shorten the patient’s rehabilitation time and speed up his/her recovery. The objective of the study is to present the principles and possibilities of therapy for patients with pusher syndrome.

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Section: Characteristics and Epidemiology Of Pusher Syndromementioning

confidence: 99%

Section: Possibilities Of Using Physiotherapy In Patients With Pusher...mentioning

confidence: 99%

Section: Possibilities Of Using Physiotherapy In Patients With Pusher...mentioning

confidence: 99%

Section: Possibilities Of Using Physiotherapy In Patients With Pusher...mentioning

confidence: 99%

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Possibilities of physiotherapeutic treatment in the case of patients with pusher syndrome

Drozd,

Nowacka-Kłos,

Hansdorfer-Korzon

2023

Fiz Pol

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Interventions for perceptual disorders following stroke

Hazelton

Thomson

Todhunter‐Brown

et al. 2022

Cochrane Database of Systematic Reviews

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Background Perception is the ability to understand information from our senses. It allows us to experience and meaningfully interact with our environment. A stroke may impair perception in up to 70% of stroke survivors, leading to distress, increased dependence on others, and poorer quality of life. Interventions to address perceptual disorders may include assessment and screening, rehabilitation, non‐invasive brain stimulation, pharmacological and surgical approaches. Objectives To assess the effectiveness of interventions aimed at perceptual disorders after stroke compared to no intervention or control (placebo, standard care, attention control), on measures of performance in activities of daily living. Search methods We searched the trials registers of the Cochrane Stroke Group, CENTRAL, MEDLINE, Embase, and three other databases to August 2021. We also searched trials and research registers, reference lists of studies, handsearched journals, and contacted authors. Selection criteria We included randomised controlled trials (RCTs) of adult stroke survivors with perceptual disorders. We defined perception as the specific mental functions of recognising and interpreting sensory stimuli and included hearing, taste, touch, smell, somatosensation, and vision. Our definition of perception excluded visual field deficits, neglect/inattention, and pain. Data collection and analysis One review author assessed titles, with two review authors independently screening abstracts and full‐text articles for eligibility. One review author extracted, appraised, and entered data, which were checked by a second author. We assessed risk of bias (ROB) using the ROB‐1 tool, and quality of evidence using GRADE. A stakeholder group, comprising stroke survivors, carers, and healthcare professionals, was involved in this review update. Main results We identified 18 eligible RCTs involving 541 participants. The trials addressed touch (three trials, 70 participants), somatosensory (seven trials, 196 participants) and visual perception disorders (seven trials, 225 participants), with one (50 participants) exploring mixed touch‐somatosensory disorders. None addressed stroke‐related hearing, taste, or smell perception disorders. All but one examined the effectiveness of rehabilitation interventions; the exception evaluated non‐invasive brain stimulation. For our main comparison of active intervention versus no treatment or control, one trial reported our primary outcome of performance in activities of daily living (ADL): Somatosensory disorders : one trial (24 participants) compared an intervention with a control intervention and reported an ADL measure. Touch perception disorder: no trials measuring ADL compared an intervention with no treatment or with a control intervention. Visu...

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Interventions for people with perceptual disorders after stroke: the PIONEER scoping review, Cochrane systematic review and priority setting project

Hazelton,

Todhunter-Brown,

Campbell

et al. 2024

Health Technol Assess

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Background Stroke often affects recognition and interpretation of information from our senses, resulting in perceptual disorders. Evidence to inform treatment is unclear. Objective To determine the breadth and effectiveness of interventions for stroke-related perceptual disorders and identify priority research questions. Methods We undertook a scoping review and then Cochrane systematic review. Definitions, outcome prioritisation, data interpretation and research prioritisation were coproduced with people who had perceptual disorders post stroke and healthcare professionals. We systematically searched electronic databases (including MEDLINE, EMBASE, inception to August 2021) and grey literature. We included studies (any design) of interventions for people with hearing, smell, somatosensation, taste, touch or visual perception disorders following stroke. Abstracts and full texts were independently dual reviewed. Data were tabulated, synthesised narratively and mapped by availability, sense and interventions. Research quality was not evaluated. Our Cochrane review synthesised the randomised controlled trial data, evaluated risk of bias (including randomisation, blinding, reporting) and meta-analysed intervention comparisons (vs. controls or no treatment) using RevMan 5.4. We judged certainty of evidence using grading of recommendations, assessment, development and evaluation. Activities of daily living after treatment was our primary outcome. Extended activities of daily living, quality of life, mental health and psychological well-being perceptual functional and adverse event data were also extracted. Results Scoping review We included 80 studies (n = 893): case studies (36/80) and randomised controlled trials (22/80). No stroke survivor or family stakeholder involvement was reported. Studies addressed visual (42.5%, 34/80), somatosensation (35%, 28/80), auditory (8.7%, 7/80) and tactile (7.5%, 6/80) perceptual disorders; some studies focused on ‘mixed perceptual disorders’ (6.2%, 5/80 such as taste–smell disorders). We identified 93 pharmacological, non-invasive brain stimulation or rehabilitation (restitution, substitution, compensation or mixed) interventions. Details were limited. Studies commonly measured perceptual (75%, 60/80), motor-sensorimotor (40%, 32/80) activities of daily living (22.5%, 18/80) or sensory function (15%, 12/80) outcomes. Cochrane systematic review We included 18 randomised controlled trials (n = 541) addressing tactile (3 randomised controlled trials; n = 70), somatosensory (7 randomised controlled trials; n = 196), visual (7 randomised controlled trials; n = 225) and mixed tactile-somatosensory (1 randomised controlled trial; n = 50) disorders. None addressed hearing, taste or smell disorders. One non-invasive brain stimulation, one compensation, 25 restitution and 4 mixed interventions were described. Risk of bias was low for random sequence generation (13/18), attrition (14/18) and outcome reporting (16/18). Perception was the most commonly measured outcome (11 randomised controlled trials); only 7 randomised controlled trials measured activities of daily living. Limited data provided insufficient evidence to determine the effectiveness of any intervention. Confidence in the evidence was low–very low. Our clinical (n = 4) and lived experience (n = 5) experts contributed throughout the project, coproducing a list of clinical implications and research priorities. Top research priorities included exploring the impact of, assessment of, and interventions for post-stroke perceptual disorders. Limitations Results are limited by the small number of studies identified and the small sample sizes, with a high proportion of single-participant studies. There was limited description of the perceptual disorders and intervention(s) evaluated. Few studies measured outcomes relating to functional impacts. There was limited investigation of hearing, smell, taste and touch perception disorders. Conclusion Evidence informing interventions for perceptual disorders after stroke is limited for all senses. Future work Further research, including high-quality randomised controlled trials, to inform clinical practice are required. Study registration This study is registered as PROSPERO CRD42019160270. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR128829) and is published in full in Health Technology Assessment; Vol. 28, No. 69. See the NIHR Funding and Awards Website for further award information.

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Therapeutic approaches for pusher syndrome after a stroke: a literature review

Cited by 3 publications

References 27 publications

Possibilities of physiotherapeutic treatment in the case of patients with pusher syndrome

Possibilities of physiotherapeutic treatment in the case of patients with pusher syndrome

Interventions for perceptual disorders following stroke

Interventions for people with perceptual disorders after stroke: the PIONEER scoping review, Cochrane systematic review and priority setting project

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