Week 3 Pusher Syndrome Flashcards
in what patients do we see pusher syndrome
in those with right or left hemisphere lesions
TF: there is evidence that co- occurrence of spatial neglect, anosognosia, aphasia and apraxia occur with pusher syndrome
false, there is no evidence
TF: neglect and aphasia are the underlying cause of pusher syndrome
false
neglect is highly associated with pushing after ___ hemisphere damage
right
aphasia is highly associated with pushing after ____ hemisphere damage
left
pusher syndrome is significantly higher in those with _(right or left)___ CVA
right
in pusher syndrome, the patient will push onto the affected or unaffected side
affected
pusher syndrome is associated with damage to the
posteriolateral thalamus
what does the posteriolateral thalamus do
involved in control of upright body posture.
lesions of the thalamic nuclei are found to be affected in those with
CP
what role does the posteriolateral thalamus play in vision
provides information about movement and cues for judging upright posture
what role does the posteriolateral thalamus play in vestibular
informs the person about head position relative to gravity and about head movements
what role does the posteriolateral thalamus play in somatosensation
provides information about weight bearing and relative position of the body parts.
are visual and vestibular processing disturbed in pusher syndrome
no, you may have a lesion of the vestibular cortex and have a tilt perceived as vertical, but this does not cause controversies pushing.
Pusher syndrome is a problem integrating
visual and vestibular information
TF: people with controversies pushing feel their COM is too far to one side, the uninvolved side, so they push themselves onto the involved side
true
what is graviception
perception of the body position equilibrium and direction of gravitational forces.
pusher syndrome is a ___ of subjective postural vertical
distortion
how does alignment to vertical change in people with pushers syndrome
eyes closed, they may think they are vertical when they are leaning. eyes open, they can use visual cues to be upright
what is the conflict with pusher syndrome
there is a mismatch between the visual and postural vertical.
what is the prognosis of pusher syndrome
evident up to 6 months, slows the progress. will take about 3.6 weeks longer to get the same functional outcomes,
TF: pushing can be well compensated by the brain
true
TF: pusher syndrome is significantly worse in people with Right CVA
true
what does pusher syndrome mean for LOS
its longer, the length of stay
what scales can we use for pusher syndrome, and what are they all about
SCP: scale for contraversive pushing
Modified SCP: 4 test conditions.
Burke Lateropulsion scale (BLS)
what are the four conditions of the modified SCP scale
- static sitting at bedside, feet on the floor
- static standing with full erect posture
- transferring from bed to chair or WC with squat pivot
- transferring from bed to chair with stand pivot
what does the BLS look at
postural alignment and degree of resistance when moving the patient passively in supine, sitting, standing, transfer and walking. a lower score is worse.
what is the recommended measure for pushing
BLS, because there are several functional tasks, and it was written in English and it is reliable and responsive
in what positions should we treat
earth vertical positions (sitting standing or walking)
TF: we want to allow pushing to occur
true, we want them to know what it feels like to fall
what do we want to make patients aware of
the vertical position, and if they are tilted, can they tell they are not upright?
how can we teach them to use their environment
explore the surroundings, and look at things like poles and doors to help orient them.
which is more effective? computer or mirror feedback
computer, interactive and addresses upright positions and body shifting to limits of stability
overall what 6 things should we include in treatment for pusher
awareness of dysfunction earth vertical positions link visual input with reality involve visual stimuli relearning movements to maintain vertical functional tasks
what is a great way to block an unwanted movement
give them a glass of water to hold in their hand, or a task, so they cannot push
is pusher syndrome recoverable
yes, but at a much slower rate
