Novel Treatment Approach to Contraversive Pushing after Acute Stroke: A Case Report

The purpose of this case report is to provide an alternative treatment approach to pushing behavior (PB), adapting widely used equipment for persons with stroke demonstrating such behaviour. The aim is to change their graviceptive experience during interventions while performing repeated stepping and righting practice to resolve PB more quickly. The subject is a man aged 56 years who sustained a right middle-cerebral-artery ischemic stroke. He entered in-patient rehabilitation from an acute care hospital 7 days post-stroke. Lateral stepping with body weight-supported treadmill training (LS-BWSTT) was used such that the subject stepped laterally toward the uninvolved side. Scores on the Scale for Contraversive Pushing and the FIM were recorded at regular intervals. After intervention, the subject demonstrated decreased PB and improved function. The individual's PB improved after LS-BWSTT. LS-BWSTT is a novel treatment intervention that could be considered in future clinical decision making using evidence-based principles.