Efectividad del feedback visual y tratamiento del equilibrio postural en el síndrome del empujador postictus. Revisión sistemática

Abstract

IntroductionPusher syndrome is characterized by the patient pushing towards the hemiparetic side with the contralateral side, in a sitting position, standing and during movement, surpassing the gravitational mean line, which produces inappropriate adjustment and postural control. ObjectiveTo determine the effectiveness of physiotherapy treatment in post-stroke pusher syndrome and to extract guidelines for its correct identification and interdisciplinary approach. MethodA systematic review was carried out (2000-2019), using the specialized databases MEDLINE, Scopus, PEDro and Web of Science. The descriptors used in the search strategies were “pusher syndrome”, “pushing behaviour”, “controversial pushing”, treatment, “physical therapy”, physiotherapy. ResultsAlthough the evidence is still limited, the intensive intervention of Physiotherapy in the patient with pusher syndrome post-stroke seems to improve the clinical symptoms in terms of severity and postural control. Among the different forms of treatment, training through visual feedback seems to be effective, especially using the Nintendo Wii balance platform. ConclusionAn individualized physiotherapeutic intervention with each patient is necessary to facilitate and guide the most effective motor strategies, work synergies between the members of the interdisciplinary team are essential (with specific guidelines on transfers and functional activities between sessions) to ensure continuity of care that guarantees achievements are maintained.