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Questions and Answers
What is the primary location of pathology associated with contraversive pushing?
What is the primary location of pathology associated with contraversive pushing?
What is the primary underlying cause of pusher syndrome?
What is the primary underlying cause of pusher syndrome?
What is the prognosis for individuals with contraversive pushing?
What is the prognosis for individuals with contraversive pushing?
Which of the following systems is NOT associated with contraversive pushing?
Which of the following systems is NOT associated with contraversive pushing?
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What is the result of a mismatch between visual and postural vertical in contraversive pushing?
What is the result of a mismatch between visual and postural vertical in contraversive pushing?
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What is the primary goal of pushing behavior in contraversive pushing?
What is the primary goal of pushing behavior in contraversive pushing?
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What is the average time it takes for patients with pusher syndrome to reach the same functional outcome as those without pusher syndrome?
What is the average time it takes for patients with pusher syndrome to reach the same functional outcome as those without pusher syndrome?
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What percentage of patients with pusher syndrome resolve at 3 months?
What percentage of patients with pusher syndrome resolve at 3 months?
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What is the main goal of rehabilitation for patients with pusher syndrome?
What is the main goal of rehabilitation for patients with pusher syndrome?
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What is the primary advantage of using the Burke Lateropulsion Scale (BLS)?
What is the primary advantage of using the Burke Lateropulsion Scale (BLS)?
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What is the recommended approach to treating patients with pusher syndrome?
What is the recommended approach to treating patients with pusher syndrome?
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What is the primary function of the Clinical Scale for Contraversive Pushing (SCP) and the Modified SCP (M-SCP)?
What is the primary function of the Clinical Scale for Contraversive Pushing (SCP) and the Modified SCP (M-SCP)?
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What is the primary goal of treatment for Pusher Syndrome?
What is the primary goal of treatment for Pusher Syndrome?
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What is the purpose of using a Nintendo Wii balance board in the treatment of Pusher Syndrome?
What is the purpose of using a Nintendo Wii balance board in the treatment of Pusher Syndrome?
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What is the key to managing transfers in Pusher Syndrome patients?
What is the key to managing transfers in Pusher Syndrome patients?
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What is the role of visual feedback in the treatment of Pusher Syndrome?
What is the role of visual feedback in the treatment of Pusher Syndrome?
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What is the purpose of using vertical structures in the treatment of Pusher Syndrome?
What is the purpose of using vertical structures in the treatment of Pusher Syndrome?
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What type of visual feedback is more effective than mirror visual feedback training in the treatment of Pusher Syndrome?
What type of visual feedback is more effective than mirror visual feedback training in the treatment of Pusher Syndrome?
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What is the effect of contraversive pushing on patient recovery?
What is the effect of contraversive pushing on patient recovery?
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What is the name of the syndrome characterized by contraversive pushing?
What is the name of the syndrome characterized by contraversive pushing?
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What is the impact of contraversive pushing on rehabilitation?
What is the impact of contraversive pushing on rehabilitation?
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What is the term for the system that is thought to be responsible for contraversive pushing?
What is the term for the system that is thought to be responsible for contraversive pushing?
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What is the relationship between contraversive pushing and inattention of the contralesional hemispace?
What is the relationship between contraversive pushing and inattention of the contralesional hemispace?
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What is the focus of the study by Dannels et al. (2004)?
What is the focus of the study by Dannels et al. (2004)?
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What is the name of the study tool mentioned in the 2008 article by Baccini M et al.?
What is the name of the study tool mentioned in the 2008 article by Baccini M et al.?
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Study Notes
Contraversive Pushing (Pusher Syndrome)
- Observed in individuals with right or left hemisphere lesions, with no evidence of co-occurrence with spatial neglect, anosognosia, aphasia, or apraxia.
- Pusher syndrome incidence is significantly higher in those with right hemisphere CVA (cerebrovascular accident).
Anatomy and Pathology
- The posterolateral thalamus is fundamentally involved in the control of upright body posture and is associated with pusher syndrome.
- Lesions of thalamic nuclei are found to be affected in individuals with contraversive pushing.
- The posterolateral thalamus is involved in processing visual, vestibular, and somatosensory information.
Clinical Presentation
- Individuals with pusher syndrome exhibit a mismatch between their visual and postural vertical, leading to a distortion of their subjective postural vertical.
- They display a pushing behavior, which is an effort to compensate for this mismatch.
Prognosis
- Pusher syndrome does not affect functional outcomes, but it can slow down the rehabilitation process.
- Individuals with pusher syndrome require 3.6 weeks longer to reach the same functional outcome as those without pusher syndrome.
- At 3 months, 83% of patients with pusher syndrome have resolved, but motor recovery and function are significantly lower compared to non-pushers.
Assessment Scales
- Clinical Scale for Contraversive Pushing (SCP) and Modified SCP (M-SCP) are used to assess pusher syndrome.
- Burke Lateropulsion Scale (BLS) is another scale used to evaluate postural alignment and degree of resistance when moving the patient passively.
Treatment Strategies
- Treatment should focus on addressing the disturbed perception of erect body position.
- Exercises should be conducted in earth-vertical positions, and visual input should be linked to reality.
- Involve visual stimuli in motor learning, and relearn movements to achieve and maintain a vertical body position.
- Integrate treatment into functional tasks, and use activities such as vertical structures, active reaching, and forward weight shift to manage transfers.
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Description
Assess your knowledge of contraversive pushing, a disorder commonly seen in patients with right or left hemisphere lesions. Identify the clinical presentation, location of pathology, and treatment strategies for recovery. Test your understanding of this neuromuscular condition.
