Effects of galvanic vestibular stimulation combined with physical therapy on pusher behavior in stroke patients: a case series

Background: A recent study investigated the effects of galvanic vestibular stimulation (GVS) on pusher behavior (PB) in post-stroke patients. However, there have been no reports about the effects of multisession GVS on PB.

Objective: The purpose of this study was to investigate the feasibility and effects of multisession GVS combined with physical therapy for PB in stroke patients.

Methods: Two stroke patients who showed PB were enrolled. The ABAB single-case design was used. Each phase lasted 1 wk. In phases A1 and A2, the patients underwent a 60-min-long physical therapy session 5 days a week. In phases B1 and B2, they underwent GVS for 20 min before each physical therapy session, and then the same physical therapy program as in phases A1 and A2 were performed. PB was evaluated using the Scale for Contraversive Pushing (SCP) and the Burke Lateropulsion Scale (BLS). Outcomes were tested at the baseline and after each phase.

Results: In both patients, the SCP scores were reduced only during phase B2. Although the BLS scores improved at the A1 phase, a larger improvement was seen at the two B phases.

Conclusions: Multisession GVS combined with physical therapy may have positive effects on PB in clinical setting.