Time to Recovery From Lateropulsion Dependent on Key Stroke Deficits A Retrospective Analysis

• Published in: Neurorehabilitation and neural repair Vol. 29; no. 3; pp. 207 - 213
• Main Authors: Babyar, Suzanne R., Peterson, Margaret G. E., Reding, Michael
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-03-2015
• Subjects: Aged; Aged, 80 and over; Functional Laterality; Humans; Kaplan-Meier Estimate; Postural Balance; Recovery of Function; Retrospective Studies; Severity of Illness Index; Stroke - complications; Stroke Rehabilitation; Treatment Outcome; lateropulsion; stroke; pusher syndrome
• ISSN: 1545-9683; 1552-6844
• DOI: 10.1177/1545968314541330

Background. Lateropulsion, a postural control disorder, delays recovery following hemispheric stroke. The number of stroke impairments may lead to differential recovery rates, depending on the intact systems available for recovery from lateropulsion. Objective. To study the impact of key postural control deficits on lateropulsion rate of recovery following stroke. Methods. Through retrospective analysis: 169 patients with hemispheric stroke in an in-patient rehabilitation facility were divided into 3 groups: (1) motor deficits only; (2) motor and hemianopic or visual–spatial deficits or motor and proprioceptive deficits; and (3) motor, proprioceptive, and hemianopic or visual–spatial deficits. Kaplan–Meier survival analysis determined if time to recovery from lateropulsion (achieving a score of 0 or 1 on the Burke Lateropulsion Scale) differed by group. Results. Log rank tests showed that time to recovery from lateropulsion differed based on the number of deficits (group, P = .012). Post hoc analyses by lesion side showed that group differences only occurred in right brain lesion (P < .05) as compared with left brain lesions (P = .34). Patients recovered from lateropulsion during in-patient rehabilitation if they had only motor deficits; those with all 3 postural control deficits showed the most protracted recovery. Conclusions. Rate of recovery from lateropulsion after stroke is dependent on the side of lesion, and number of key motor, proprioceptive, and/or hemianopic or visual–spatial deficits. The more postural control systems affected, the slower the recovery. Our data identify patients likely to need protracted rehabilitation targeting key postural control deficits.