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Related Experiment Videos

Understanding and treating "pusher syndrome".

Hans-Otto Karnath1, Doris Broetz

  • 1Department of Cognitive Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Hoppe-Seyler-Str 3, D-72076 Tuebingen, Germany. Karnath@uni-tuebingen.de

Physical Therapy
|December 4, 2003
PubMed
Summary

Pusher syndrome, a disorder from brain damage, causes patients to actively push away from their unaffected side, leading to balance loss. New research reveals altered perception of body orientation and suggests a visual-based physical therapy approach.

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Area of Science:

  • Neuroscience
  • Clinical Neurology
  • Rehabilitation Medicine

Background:

  • Pusher syndrome is a neurological disorder characterized by active pushing away from the nonhemiparetic side, resulting in loss of postural balance after brain damage.
  • The underlying anatomical and mechanistic basis of pusher syndrome has been a subject of recent investigation.

Purpose of the Study:

  • To identify the mechanism and related anatomy responsible for pusher syndrome.
  • To propose a novel physical therapy approach for pusher syndrome patients based on new insights.

Main Methods:

  • Investigated patients with severe pusher behavior.
  • Assessed perception of body posture in relation to gravity.
  • Evaluated processing of visual and vestibular inputs for visual vertical perception.

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Main Results:

  • Patients with pusher syndrome experience altered perception of body posture, perceiving themselves as upright when tilted towards the side of the brain lesion (ipsilesional side).
  • Crucially, these patients demonstrate intact processing of visual and vestibular inputs for determining visual vertical.
  • This preserved visual vertical processing forms the basis for a new therapeutic strategy.

Conclusions:

  • The study elucidates the altered perception of body orientation in pusher syndrome.
  • A new physical therapy approach is proposed, leveraging the preserved visual control of vertical orientation in affected patients.
  • This approach aims to improve postural balance by utilizing intact visual processing mechanisms.