Neuro Summary 5-10 Exam (PDF)

5.4 interventions for contraversive pushing contraversive/ipsi pushing (pushers syndrome) occurs in 20% of pts post stroke good prognosis longer recovery time for fxnal gains (in comparison to pt who doesnt have pushers) -pushing is severe in beginning *watch video* pt pushes himself w his foot & ca...

5.4 interventions for contraversive pushing contraversive/ipsi pushing (pushers syndrome) occurs in 20% of pts post stroke good prognosis longer recovery time for fxnal gains (in comparison to pt who doesnt have pushers) -pushing is severe in beginning *watch video* pt pushes himself w his foot & cant right himself back into neutral general approaches to tx contraversive pusher syndrome -environmental cues/orientation -visual feedback -tactile feedback l -for perceptual deficit *AVOID PUSHING BACK*: causes them to push to paretic side more frequent redirection & orientation guide not push goal: have pt ACTIVELY move toward non-paretic side rehab interventions alignment in midline *key* a. once position maintained>>wt shift toward nonparetic side wt shifting using visual feedback remove pushing extremity: so they dont use bc it can make it worse a. could have pt hold their own arm b.constant redirection use of environment a. straight lines/objects - for visual alignment & wt shift for gait b. tape lines on wall - c. tactile feedback from tables transfer toward paretic (pts w NO pusher syn) -promotes forces use & increase cortical excitability for neural plasticity of more involved side pushers: increased cortical excitability + recognize midline