- Contraversive Pushing
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Questions and Answers

What is the primary location of pathology associated with contraversive pushing?

  • Left or Right Posteriolateral thalamus (correct)
  • Left or Right Hemisphere lesions
  • Somatosensory cortex
  • Vestibular cortex

    • What is the primary underlying cause of pusher syndrome?

  • Damage to the visual cortex
  • Neglect and Aphasia
  • Lesions of thalamic nuclei
  • Distortion of subjective postural vertical (correct)

    • What is the prognosis for individuals with contraversive pushing?

  • The disorder has a significant impact on functional outcomes
  • The disorder is highly associated with spatial neglect
  • The disorder is rarely still evident at 6 months (correct)
  • The disorder is often co-occurring with anosognosia

    • Which of the following systems is NOT associated with contraversive pushing?

    <p>Auditory system</p> Signup and view all the answers

    What is the result of a mismatch between visual and postural vertical in contraversive pushing?

    <p>A distortion of subjective postural vertical</p> Signup and view all the answers

    What is the primary goal of pushing behavior in contraversive pushing?

    <p>To compensate for a mismatch between visual and postural vertical</p> Signup and view all the answers

    What is the average time it takes for patients with pusher syndrome to reach the same functional outcome as those without pusher syndrome?

    <p>3.6 weeks</p> Signup and view all the answers

    What percentage of patients with pusher syndrome resolve at 3 months?

    <p>83%</p> Signup and view all the answers

    What is the main goal of rehabilitation for patients with pusher syndrome?

    <p>To shorten rehabilitation time</p> Signup and view all the answers

    What is the primary advantage of using the Burke Lateropulsion Scale (BLS)?

    <p>It is more reliable and responsive than other scales</p> Signup and view all the answers

    What is the recommended approach to treating patients with pusher syndrome?

    <p>Treating in earth vertical positions and allowing pushing to occur</p> Signup and view all the answers

    What is the primary function of the Clinical Scale for Contraversive Pushing (SCP) and the Modified SCP (M-SCP)?

    <p>To identify contraversive lateropulsion across several functional tasks</p> Signup and view all the answers

    What is the primary goal of treatment for Pusher Syndrome?

    <p>To correct the patient's perception of their body position</p> Signup and view all the answers

    What is the purpose of using a Nintendo Wii balance board in the treatment of Pusher Syndrome?

    <p>To address maintaining vertical body posture and rhythmic body shifting</p> Signup and view all the answers

    What is the key to managing transfers in Pusher Syndrome patients?

    <p>Forward weight shift</p> Signup and view all the answers

    What is the role of visual feedback in the treatment of Pusher Syndrome?

    <p>To link visual input to reality and facilitate motor learning</p> Signup and view all the answers

    What is the purpose of using vertical structures in the treatment of Pusher Syndrome?

    <p>To help the patient see that they are or are not oriented upright</p> Signup and view all the answers

    What type of visual feedback is more effective than mirror visual feedback training in the treatment of Pusher Syndrome?

    <p>Computer-generated interactive visual feedback</p> Signup and view all the answers

    What is the effect of contraversive pushing on patient recovery?

    <p>It slows down recovery, but is still recoverable</p> Signup and view all the answers

    What is the name of the syndrome characterized by contraversive pushing?

    <p>Pusher Syndrome</p> Signup and view all the answers

    What is the impact of contraversive pushing on rehabilitation?

    <p>It negatively impacts rehabilitation</p> Signup and view all the answers

    What is the term for the system that is thought to be responsible for contraversive pushing?

    <p>Second graviceptive system</p> Signup and view all the answers

    What is the relationship between contraversive pushing and inattention of the contralesional hemispace?

    <p>They are closely linked</p> Signup and view all the answers

    What is the focus of the study by Dannels et al. (2004)?

    <p>The natural history of contraversive pushing</p> Signup and view all the answers

    What is the name of the study tool mentioned in the 2008 article by Baccini M et al.?

    <p>Scale for Contraversive Pushing</p> Signup and view all the answers

    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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    Related Documents

    Week 3.3.5 Pusher Syndrome Handouts PDF

    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.

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