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Immediate effectiveness of single-session therapeutic interventions in pusher behaviour
Carmen Krewer1, Katrin Rieß, Jeannine Bergmann
1Schön Klinik Bad Aibling, Germany. Bad Aibling, CKrewer@schoen-kliniken.de
Gait & Posture
|August 15, 2012
Summary
Stroke patients with pusher behavior, characterized by leaning towards the hemiparetic side, showed improvement with Lokomat therapy. This machine-supported gait training effectively reduced lateropulsion, aiding rehabilitation.
Area of Science:
- Neurorehabilitation
- Biomechanics
- Clinical Neurology
Background:
- Pusher behavior, a common post-stroke complication, significantly impairs postural balance and hinders rehabilitation.
- Limited research exists on effective treatment strategies for pusher behavior.
Purpose of the Study:
- To investigate the immediate effects of galvanic vestibular stimulation (GVS), Lokomat (machine-supported gait training), and physiotherapy with visual feedback (PT-vf) on pusher behavior.
Main Methods:
- An observer-blinded, cross-over pilot study involving 15 pusher and 10 non-pusher stroke patients.
- Assessment using the Scale for Contraversive Pushing (SCP) and Burke Lateropulsion Scale (BLS) before and after single-session interventions.
Main Results:
- Lokomat therapy demonstrated a significant effect on the BLS in pusher patients compared to PT-vf.
- Neither Lokomat nor GVS significantly affected SCP values.
- The BLS proved more sensitive than SCP for detecting changes in clinical trials and routine treatment.
Conclusions:
- Machine-supported gait training (Lokomat) may be effective in immediately reducing pusher behavior in stroke patients.
- This effect might stem from recalibrating the sense of verticality through somatic graviception.
- Further research on repetitive, multi-session therapy is warranted to assess long-term efficacy.
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