pusher syndrome Flashcards
define pusher syndrome
- a condition observed in individuals that have had a stroke or other brain injury - - the patient leans towards the hemiplegic side (affected side opposite to the lesion in brain) in any posture and resists any passive correction of posture
what is contraversive pushing?
pushing actively with the non affected extremities to the side contralateral to the brain lesion or the affected side
what is the incidence or rate of pushers syndrome occurring?
-present in more severe strokes
-evenly divided R & L sided stroke
-greater deficits in those with neglect, mobility, dysphagia (swallowing) or aphasia (not speaking)
what are the possible causes of pusher syndrome?
-damage to sensory pathways
-some damage to the thalamus (sensory centre),temporal regions etc
what is the graviceptive system?
refers to the sensory mechanisms that help the body perceive and respond to gravity
ie vestibular system
proprioceptive system
somatosensory system
what are the implications (effects/consequences) of pusher syndrome?
-balance control in sitting, standing and walking
-ADLs eg washing, dressing, toileting and feeding
-safety - falls risk
-functional mobility - bed mobility and transfers
what are the clinical findings of pushers syndrome?
-patients leads to semi/ affected side
-resists any attempt to correct posture which moves bodyweight to midline
-unable to accept weight through unaffected side
-over activity of unaffected side - UL,LL & trunk
what does assessment of pusher syndrome involve?
-diagnosis made by observation
-asymmetrical posture
-lack of midline sitting
-actively pushes to affected side
-visuospatial neglect
describe the management of pusher syndrome
-restore the sense of their midline
-balance training
-regain ability to move actively towards that side with visual cueing and feedback
-regain ability to move actively about in sitting and standing
-working on standing on parallel bars (upright posture, alignment and sense of midline)
