Document Type

Journal Article

Publication Title

Topics in Stroke Rehabilitation

PubMed ID



Taylor & Francis


School of Medical and Health Sciences




Raine Medical Research Foundation/Western Australian Department of Health Clinician Research Fellowship / Charlies Foundation for Research / Australian Government Research Training Programme Scholarship


This is an Accepted Manuscript of an article published by Taylor & Francis in TOPICS IN STROKE REHABILITATION on 25th March 2024, available online:

Nolan, J., Jacques, A., Godecke, E., Bynevelt, M., Dharsono, F., & Singer, B. (2024). Lateropulsion resolution and outcomes up to one year post-stroke: A prospective, longitudinal cohort study. Topics in Stroke Rehabilitation. Advance online publication.


Background: Post-stroke lateropulsion is prevalent and associated with poor rehabilitation outcomes; however, data regarding long-term function associated with lateropulsion are lacking. Objectives: This study aimed to explore lateropulsion resolution and associations between lateropulsion, functional outcomes, and fall occurrence up to 12 months post-stroke. Methods: Participants for this prospective, longitudinal cohort study were recruited from a Stroke Rehabilitation Unit (SRU). Assessments were conducted at SRU admission, at discharge, and at three, six, nine, and twelve months post-stroke. Outcomes included the Four-Point Pusher Score (4PPS), Functional Independence Measure (FIM), and fall occurrence. Longitudinal outcomes were modeled using generalized linear mixed-effects models. Results: The final analyses included data from 144 participants. Eighty-two participants (56.9) had lateropulsion (4PPS ≥ 1) on admission. Odds of resolved lateropulsion (4PPS = 0) increased longitudinally from discharge for people who participated in rehabilitation physiotherapy (OR: 9.7, 28.1, 43.1, 81.3: < 0.001 at three, six, nine, and twelve months respectively). The greatest FIM improvement among participants in all 4PPS categories occurred during the SRU inpatient phase. The probability of falls post-discharge was greatest among participants with 4PPS = 1 at three months, when compared with 4PPS = 0 (p= 0.022). Conclusions: This study showed that lateropulsion can continue to resolve up to one year post-stroke. Earlier lateropulsion resolution was associated with ongoing rehabilitation physiotherapy participation. Long-term functional gains were maintained among people discharged home, whereas functional status deteriorated after six months among those in residential care. Study findings will allow rehabilitation and service providers to better plan for and accommodate the long-term rehabilitation and care needs of people with post-stroke lateropulsion.



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