![]() The panel critiqued manuscripts according to predetermined criteria about clinical and clinimetric properties.įour manuscripts referencing three tools for examining lateropulsion were found. Five abstracts were reviewed and the panel agreed to omit one abstract because those authors did not write a full manuscript. A panel of experts then determined which should be included in this review. Databases were searched from their inception to October 2008.Ībstracts were selected by one author. ![]() Search through electronic databases (MEDLINE, EMBASE, CINAHL, Science Citation Index) with the terms lateropulsion, pushing, pusher syndrome, validity, reliability, internal consistency, responsiveness, sensitivity, specificity, posture and stroke. To examine the clinimetric properties and clinical applicability of published tools for 'quantifying' the degree of lateropulsion or pusher syndrome following stroke. Uprightness is predominantly controlled from the right hemisphere. Post-stroke lateropulsion prevalence is high, which appeals for its systematic detection to guide early interventions. After infratentorial stroke, lateropulsion prevalence was very high, reaching 83.2% (95%CI ). The ratio of right- to left-hemispheric stroke with lateropulsion increased as a function of time: 1.7 in the acute phase to 7.7 in the late subacute phase. Lateropulsion prevalence progressively decreased from 52.8% (95%CI ) in the acute phase to 37% (95%CI ) in the early subacute phase and 22.8% (95%CI ) in the late subacute phase. Meta-regression did not reveal any effect of age, sex, geographic region, publication year, or study quality. ![]() After supratentorial stroke, lateropulsion prevalence was 41% (95%CI ), and only 12.5% (95%CI ) in individuals with severe lateropulsion, called pushers. The pooled lateropulsion prevalence was 55.1% (95% confidence interval ) and was consistent across assessment tools. The studies’ quality was adequate, with only 8 (36.4%) showing risk of bias. We identified 22 studies (5125 individuals mean age 68.5 years 42.6% female assessed 24 days, on average, after stroke), most published after 2000. A random-effects meta-analysis was used to obtain the pooled prevalence, whose heterogeneity was investigated by subgroup analysis (stroke locations and post-stroke phases) and meta-regression. Eligibility for inclusion, data extraction, and study quality (Joanna Briggs Institute guidelines) were evaluated by two reviewers who used a standardized protocol: PROSPERO (CRD42020175037). We systematically searched MEDLINE, EMBASE, CINAHL, and Cochrane Clinical Trials up to for original research reporting a prevalence or incidence of post-stroke lateropulsion. The objectives of this study were to bridge this gap. Efforts to design specific interventional studies require some basic knowledge of epidemiology, which is insufficient today because many studies focused on a few severe forms in individuals called pushers. It magnifies mobility limitations and so represents an emerging target in rehabilitation. Lateropulsion is a deficit of active body orientation with respect to gravity in the frontal plane, mostly observed after a stroke. This group recommends that ‘lateropulsion' is used in future research and in clinical practice. ![]() 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’. ![]() Improved understanding of the condition could lead to improved management, which will enhance patient outcomes after stroke and increase efficiency of healthcare resource utilisation. As a part of the process, the panel agreed to aim to reach consensus regarding terminology used to describe the condition. 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.Ĭommencing in 2021, 20 international experts undertook a Delphi Process that aimed to compile clinical practice recommendations for the rehabilitation of lateropulsion. ![]()
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