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

Document Type

Journal Article

Publication Title

Physiotherapy Canada


University of Toronto Press


School of Medical and Health Sciences




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.


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.



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