A new treatment of Pusher syndrome based on central integration concept

Abstract

To observe the effect of central integration concept based treatment on Pusher Syndrome after stroke and illustrate the relationship between cognition integration and motor control after stroke, providing a new potential way to treat stroke. Thirty stroke patients with Pusher Syndrome who were unable to maintain sitting and standing balance were included in this study. The experimental group (15 cases) received the treatment based on central integration concept mainly including: 1. Dynamic assessment showed the major dysfunction of patients was lack of directional and spatial ability. 2. Auditory and visual information was inputted and the appropriate environment were set accordingly, making the brain regain sequential cognitive function and the subjects actively establish the directional and spatial ability in static and dynamic sitting and standing process. 3. A 24-hour rehabilitation management was used to strengthen the spatial direction ability and the formation of implicit memory. The control group (15 cases) adopted routine rehabilitation training methods (sitting and standing balance training, muscle strength training, core control training, etc.). Fugl-Meyer balance scale and ADL scale (Modified Barthel Index) were used for functional assessment before and after 1 week of treatment. Time to reconstruct sitting and standing balance were recorded also. Compared with the control group, the time to regain sitting and standing balance was significantly shorter. No significant difference showed between two groups before treatment. Experimental group demonstrated significantly higher scores both in Fugl-Meyer balance scale ( P < 0.001) and ADL (modified Barthel index) scale ( P < 0.001) after 1 week of treatment. Compared with the conventional rehabilitation training, central integration based treatment can effectively improve balance function and ADL ability of patients with Pusher syndrome after stroke so as to shorten the hospitalization period and return to family and society as soon as possible.