Feedback Interventions in Motor Recovery of Lateropulsion after Stroke: A Literature Review and Case Series
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Protocol
2.2. Search Strategy, Eligibility Criteria, and Data Extraction
2.3. Case Series
2.3.1. Patients Included and International Classification of Functioning Diagnosis
2.3.2. Treatment Approach
2.3.3. Outcome Variables and Evaluation
3. Results
3.1. Selection of Studies for the Review
3.2. Results from the Review
3.2.1. Lateropulsion
3.2.2. Balance
3.2.3. Motor Function
3.2.4. Functional Independence
3.2.5. Other Outcomes
3.3. Results from the Case Series
4. Discussion
4.1. Discussion Related to the Review
4.1.1. Lateropulsion
4.1.2. Balance
4.1.3. Motor Function
4.1.4. Functional Independence
4.1.5. Other Outcomes
4.2. Case Series Discussion
4.3. Limitations of this Review and Case Series Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Databases | Search Strategy |
---|---|
Embase | feedback system AND (lateropulsion OR “pusher syndrome” OR “pusher behavior” OR “contraversive pushing”) |
Medline/PubMed Web of Science Scopus | feedback AND (lateropulsion OR pusher OR “pusher syndrome” OR “pusher behavior” OR “contraversive pushing”) |
PEDro | “Pusher behavior”, “pusher syndrome”, “contraversive pushing”, and “lateropulsion” combined with “feedback” as keywords (simple search) |
Case 1 | Case 2 | |
---|---|---|
Sex | Male | Female |
Age | 53 | 69 |
Type of stroke | Hemorrhagic | Ischemic |
Hemisphere affected | Left | Right |
Time post stroke (days) | 33 | 6 |
Authors (Year) | Study Type (n) | Age (Years)/TPS | Intervention | Dose | Outcome Measurements | Results |
---|---|---|---|---|---|---|
Nakamura et al. (2023) [54] | CR 1 | 67/ 48 days | 3 interventions phases: A: Balance and gait training with VF. B: Exercises focused on SI (loads, closed eyes, etc.) and balance and gait training. FU: balance and gait training without VF or SI | 9 sessions (1 h)/12 days. Total of 9 sessions | SARA, BBS, mCTSIB (force platform), H-reflex from soleus, VST excitability, SVV | SARA and BBS improvement occurred mainly after phase A. Generally better performance of mCTSIB after phase B and FU. VST excitability did not change on the affected side. SVV did not change significantly throughout the study. |
Lee et al. (2017) [55] | CS 3 | 61.67/ 2.3 months avg. | Routine PT, SPV VF+, and SPV VF−. Alternating treatments with multiple baseline measures | 3 sessions (1 h)/week. Total of 18 sessions | SCP, PASS, BI SCP-b = 5 | Relative to baseline, all interventions showed improvement. BI, SCP, and PASS scores improved after SPV VF− training compared to after SPV VF+ training in a longer intervention stage. |
Yang et al. (2015) [56] | RCT 12 (EG = 7; CG = 5) | 60 ± 15.1/5.9 ± 3.65 months | Computer-generated VF (via Nintendo Wii balance board) or mirror VF | 3 sessions (20 min VF + 20 min PT)/week for 3 weeks. Total of 9 sessions | SCP, BBS, FMA, SCP-b = 4.65 ± 1.05 | Both interventions were associated with decreased lateropulsion and improvement of balance (significant difference between groups in favor of experimental: p < 0.01 and p < 0.05, respectively). |
Krewer et al. (2013) [57] | RCT (cross-over) 25 (15 pusher and 10 non-pusher) | 65.5 ± 9.5/ 7.7 ± 6.9 months | GVS, DGO, and PT-VF | 1 single session of each type. Total of 3 sessions | SCP, BLS, SCP-b = not found | No statistically significant difference between interventions according to SCP. BLS results showed significant improvement after DGO compared to after PT-VF (p < 0.05). Other comparisons did not show significant difference. |
Broetz et al. (2004) [58] | CS 8 | 63 avg./ 4 days avg. | VF (exploring surrounding vertical features) | 6 sessions (30 min)/week within 26 days approx. Total of 22 sessions approx. | SCP, SCP-b = not found | Lateropulsion improved significantly after 3 weeks (p < 0.05). At day 24, six patients sufficiently recovered, achieving the sitting position unsupported (p < 0.05). |
Paci et al. (2004) [59] | CR 1 | 71/ 27 days | Bobath concept, specific pushing activities (somatosensory inputs), and AF and VF (line in mirror) | 6 sessions (2 h PT twice a day from Monday to Friday and 1 h on Saturdays)/week. Total of 27 sessions | SCP, FMA, MA, BI, MAS, SCP-b = 4.75 | Immediate effects after feedback but not after somatosensory approach. No maintenance of these effects to the end of treatment. Lateropulsion was reduced only partially. |
Results | Case 1 | Case 2 | ||||||
---|---|---|---|---|---|---|---|---|
ICF | Variable | Scale/Test | Pre-Test | Post-Test | Follow-Up | Pre-Test | Post-Test | Follow-Up |
Body function (b) | Lateropulsion | SCP | 5.75 | 1.75 | 0 | 5 | 4 | 2.25 |
BLS | 11 | 3 | 0 | 10 | 10 | 5 | ||
Balance | PASS | 12 | 20 | 26 | 7 | 12 | 17 | |
TIS | 2 | 16 | 17 | 2 | 8 | 8 | ||
POMA | 0 | 8 | 12 | 0 | 1 | 1 | ||
Gait | 50 M | No | Yes | Yes | No | No | No | |
FAC | 0 | 1 | 1 | 0 | 0 | 1 | ||
Pain | SF-MPQ | 0 | 0 | 0 | 14 | 6 | 0 | |
Activity and Participation (d) | Functional independence | MRS | 5 | 5 | 4 | 5 | 5 | 5 |
BI | 30 | 40 | 50 | 35 | 40 | 35 | ||
Two previous (b, d) and Environmental Factors (e) | Quality of live, anxiety, and depression | ECVI-38 | 74.95 | 49.30 | 51.04 | 57.18 | 45.94 | 51.64 |
HADS | 22 | 11 | 17 | 9 | 15 | 22 |
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Gomez-Risquet, M.; Hochsprung, A.; Magni, E.; Luque-Moreno, C. Feedback Interventions in Motor Recovery of Lateropulsion after Stroke: A Literature Review and Case Series. Brain Sci. 2024, 14, 682. https://doi.org/10.3390/brainsci14070682
Gomez-Risquet M, Hochsprung A, Magni E, Luque-Moreno C. Feedback Interventions in Motor Recovery of Lateropulsion after Stroke: A Literature Review and Case Series. Brain Sciences. 2024; 14(7):682. https://doi.org/10.3390/brainsci14070682
Chicago/Turabian StyleGomez-Risquet, Maria, Anja Hochsprung, Eleonora Magni, and Carlos Luque-Moreno. 2024. "Feedback Interventions in Motor Recovery of Lateropulsion after Stroke: A Literature Review and Case Series" Brain Sciences 14, no. 7: 682. https://doi.org/10.3390/brainsci14070682