Post-stroke lateropulsion terminology: pushing for agreement amongst experts

Jessica Nolan; Angela Jacques; Erin Godecke; Hiroaki Abe; Suzanne Babyar; Jeannine Bergmann; Melissa Birnbaum; Shenhao Dai; Cynthia Danells; Taiza Gs Edwards; Marialuisa Gandolfi; Klaus Jahn; Ryan Koter; Avril Mansfield; Junji Nakamura; Vicky Pardo; Dominic Perennou; Celine Piscicelli; David Punt; Devra Romick-Sheldon; Wim Saeys; Nicola Smania; Nathalie Vaes; Abigail L Whitt; Barbara Singer

doi:10.1016/j.rehab.2022.101684

Post-stroke lateropulsion terminology: pushing for agreement amongst experts

Ann Phys Rehabil Med. 2022 Nov;65(6):101684. doi: 10.1016/j.rehab.2022.101684. Epub 2022 Aug 5.

Authors

Jessica Nolan¹, Angela Jacques², Erin Godecke³, Hiroaki Abe⁴, Suzanne Babyar⁵, Jeannine Bergmann⁶, Melissa Birnbaum⁷, Shenhao Dai⁸, Cynthia Danells⁹, Taiza Gs Edwards¹⁰, Marialuisa Gandolfi¹¹, Klaus Jahn¹², Ryan Koter¹³, Avril Mansfield¹⁴, Junji Nakamura¹⁵, Vicky Pardo¹⁶, Dominic Perennou⁸, Celine Piscicelli⁸, David Punt¹⁷, Devra Romick-Sheldon¹⁸, Wim Saeys¹⁹, Nicola Smania²⁰, Nathalie Vaes²¹, Abigail L Whitt²², Barbara Singer²³

Affiliations

¹ School of Medical and Health Sciences, Edith Cowan University, Osborne Park Hospital, Joondalup, Stirling, Australia. Electronic address: jess.nolan@health.wa.gov.au.
² Institute for Health Research, The University of Notre Dame Australia, Department of Research, Sir Charles Gairdner Hospital, Fremantle, Nedlands, Australia.
³ School of Medical and Health Sciences, Sir Charles Gairdner Hospital, Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Edith Cowan University, Joondalup, Melbourne, Nedlands, Vic, Australia.
⁴ Fukushima Medical University, Fukushima, Japan.
⁵ Hunter College, Burke Rehabilitation Hospital, New York, White Plains, NY, United States.
⁶ Schoen Clinic, Ludwig-Maximilians University of Munich, German Center for Vertigo and Balance Disorders (DSGZ), Bad Aibling, Munich, Germany.
⁷ St Vincent's Hospital, Melbourne, Vic, Australia.
⁸ UMR CNRS 5105 Neuropsychology and NeuroCognition, Univ. Grenoble Alpes, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 cedex 9 Grenoble, France.
⁹ KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
¹⁰ Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil.
¹¹ Department of Neurosciences, Biomedicine and Movement Sciences, Neurorehabilitation Unit, AOUI Verona, Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), University of Verona, Verona, Italy.
¹² Schoen Clinic, German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich, Bad Aibling, Munich Germany.
¹³ Sherherd Center, Atlanta, GA, United States.
¹⁴ KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Sunnybrook Research Institute, Toronto, ON, Canada.
¹⁵ Nishiyamato Rehabilitation Hospital, Graduate School of Health Sciences, Kio University, Nara, Japan.
¹⁶ Wayne State University, Detroit, MI, United States.
¹⁷ University of Birmingham, Birmingham, UK.
¹⁸ Schwab Rehabilitation Hospital, Chicago, IL, United States.
¹⁹ University of Antwerp, Rehabilitation Sciences and Physiotherapy, Wilrijk, Belgium.
²⁰ Neurorehabilitation Unit, AOUI Verona, Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
²¹ Rehabilitation Hospital RevArte, Antwerp, Belgium; Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
²² Inova Fairfax Hospital Health System, Fairfax, VA, United States.
²³ School of Medical and Health Sciences, Training Centre in Subacute Care, South Metropolitan Health Service, Edith Cowan University, Fremantle Hospital, Fremantle, Joondalup, WA, Australia.

PMID: 35667626
DOI: 10.1016/j.rehab.2022.101684

Abstract

Post-stroke lateropulsion is prevalent. The global inconsistency in terminology used to describe the condition presents obstacles in accurately comparing research results, reaching consensus on use of measurement tools, agreeing upon a consistent approach to rehabilitation, and translating research to clinical practice. Commencing in 2021, 20 international experts undertook a Delphi Process that aimed to compile clinical practice recommendations for the rehabilitation of lateropulsion. As a part of the process, the panel agreed to aim to reach consensus regarding terminology used to describe the condition. Improved understanding of the condition could lead to improved management, which will enhance patient outcomes after stroke and increase efficiency of healthcare resource utilisation. While consensus was not reached, the panel achieved some agreement that 'lateropulsion' is the preferred term to describe the phenomenon of 'active pushing of the body across the midline toward the more affected side, and / or actively resisting weight shift toward the less affected side'. This group recommends that 'lateropulsion' is used in future research and in clinical practice.

Keywords: Lateropulsion; Pusher behaviour; Pusher syndrome; Stroke rehabilitation.

Publication types

Letter

MeSH terms

Humans
Postural Balance
Stroke Rehabilitation*
Stroke*