Post-stroke lateropulsion: Resolution and function after discharge from inpatient rehabilitation - A cohort study

Document Type

Journal Article

Publication Title

Physiotherapy Canada

Publisher

University of Toronto Press

School

School of Medical and Health Sciences

RAS ID

56682

Comments

Nolan, J., Godecke, E., Spilsbury, K., & Singer, B. (2022). Post-Stroke Lateropulsion: Resolution and Function After Discharge From Inpatient Rehabilitation–A Cohort Study. Physiotherapy Canada, 75(3), 264-268. https://doi.org/10.3138/ptc-2021-0078

Abstract

Purpose: A person with post-stroke lateropulsion pushes their body toward their hemiparetic side and/or resists accepting weight onto their nonparetic side. Research findings regarding long-term persistence of lateropulsion and its association with function are lacking. This study reports associations between lateropulsion severity (Four Point Pusher Score – 4PPS) and functional outcome (Functional Independence Measure – FIM) at three months after discharge. Methods: This prospective cohort study included 41 consecutive admissions to a stroke rehabilitation unit. Lateropulsion severity and FIM were measured at admission, discharge and three-month follow-up. Lateropulsion status at discharge, stroke laterality, ongoing physiotherapy after discharge, and demographic variables (age and sex) were tested for association with FIM change over the follow-up period. Results: Complete data were available for 38 participants. Among these, 17 (44.7%) showed lateropulsion (4PPS ≥ 1) on admission, 9 (23.7%) showed persistent lateropulsion on discharge, and 7 (18.4%) showed persistent lateropulsion at three month follow-up. Improved functional status (FIM score) was seen at follow-up in those discharged with lateropulsion who had right-sided lesions but not in those with left-sided lesions. Conclusions: Lateropulsion can continue to resolve after discharge from inpatient rehabilitation. Larger cohort studies are needed to further explore associations between persistent lateropulsion and long-term outcomes.

DOI

10.3138/ptc-2021-0078

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