Effects of Prone Posture Maneuver to Ameliorate Pusher Behavior in Acute Stroke: A Retrospective Study

Background: Pusher behavior after stroke is an important sequela that interferes with rehabilitation and independence in activities of daily living. As represented by visual or vestibular feedback, conventional methods require substantial assistance and time commitments, but have limited effectiveness. A recent case series suggests that prone posture may alleviate pusher behavior in patients with acute stroke. This study was conducted to retrospectively investigate the effects of prone posture maneuvers. Methods: This retrospective cross-sectional observational study was conducted in a stroke care unit at a university hospital. In total, 37 acute stroke cases presenting with pusher behavior were included from 787 eligible patients. Individuals with pusher behavior were conditioned with prone posturing for 10 min for 2 consecutive days, in addition to regular daily rehabilitation training. The Scale for Contraversive Pushing (SCP) values, Stroke Impairment Assessment Set (SIAS), and functional activities were assessed before, immediately after, and three days after the intervention. Results: The SCP value and the ability to roll over and sit balanced significantly improved compared with the baseline (p < 0.05) and persisted for 3 days after the intervention. Multiple regression analysis identified the SIAS motor score as a determinant of SCP changes. Conclusions: The prone posture maneuver promptly and consistently suppressed pusher behavior, particularly in patients with mild paresis, as indicated by SCP values in acute stroke cases. The uncontrolled, single-site, and retrospective features of the current study require further investigation.