Study of the burke lateropulsion scale to evaluate Pusher syndrome rehabilitation

Abstract

Background: Pusher syndrome is a position-control disorder with a higher incidence in patients after stroke. Clinical studies have shown that patients with Pusher syndrome hospitalize for a long time and daily function after discharge are low, so early detection and treatment is critical to control the development of the disease; Burke lateropulsion scale (BLS) can be used to diagnose Pusher syndrome and can effectively and accurately reflect the changing aspects of patient movement, but now BLS has not been widely used in clinical work. Purpose:To study about the sensitivity ofBLSon changes ofPusher syndromeand the clinical features in the application of BLS as the evaluation tool in order to provide a theoretical basis for BLS’s clinical application. Methods: Patients were scored by BLS since the first day of admission, and in every two weeks till discharged. After admission, conventional motor function training were given, motor relearning and Bobath therapy mainly, including rollover, stand-up, sit-up, sit station transfer, balance training, walking training, etc. Each patient has been evaluated at least three times during hospitalization. Results: Of 48 patients, 56.3% were evaluated as mild of Pusher syndrome and 16.7% severe at admission. While at discharge, 47.9% were classified as mild, 43.8% were not diagnosed as Pusher syndrome and none severe. SRM was 1.27 during the whole hospitalization, 1.41 in 4 weeks and 2.18 in 6 weeks. Conclusion(s): The BLS is an appropriate tool for the evaluation of Pusher syndrome patients and is responsive to monitor progress and recovery during rehabilitation. It is significant to guide rehabilitation if used in routine clinical practice. It could be suitable to evaluate changes in future intervention studies. Implications: With the wide and routine use of BLS in patients after stroke, especially in those with Pusher syndrome, it will be a sensitive tool in monitor the progress during rehabilitation which gives an accurate feedback on therapy and helps with the treatment prescription adjustment in time.