Category: Stroke; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : Despite the documented negative functional and financial implications of lateropulsion (also known as "pushing") in the post-stroke population, little research has focused on improving this phenomenon more rapidly in a patient's recovery.
Design : Case report
Setting : Large urban inpatient rehabilitation hospital
Participants (or Animals, Specimens, Cadavers) : A 58 year old male was admitted to an inpatient rehabilitation hospital with large frontoparietal intracerebral hemorrhage resulting in significant left hemiparesis with sensory and cognitive involvement as well as lateropulsion.
Interventions : A standing frame protocol was implemented into standard of care to improve lateropulsion. Incorporated into standard care, the patient was assisted into a standing frame daily for approximately 30 minutes.
Main Outcome Measure(s) :
The following outcome measures were assessed: Burke Lateropulsion Scale (BLS), Functional Independence Measure (FIM), and the Stroke Rehabilitation Assessment of Movement (STREAM).
Results : The patient made improvements in all outcome measures and when compared to normative data, improvements were greater for both the BLS and the FIM.
The findings are encouraging and warrant further study through a case series or feasibility study to determine the impact of a standing frame protocol incorporated into care for a patient with lateropulsion.
Jaime Gillespie– Physical Therapist, Baylor Scott & White Institute for Rehabilitation, Dallas, Texas