Physiotherapy for pusher behaviour in a patient with post-stroke hemiplegia.
OBJECTIVE
This case report describes a specific, literature-based physiotherapy treatment and the outcome for a stroke patient with pusher behaviour. Pusher behaviour is characterized by pushing strongly towards the hemiplegic side in all positions and resisting any attempt at passive correction of posture to bring the weight towards or over the midline of the body.


METHODS
The patient was a 71-year-old man with clear pusher behaviour due to a stroke. Therapy for the pushing behaviour was performed over a 3-week period. Motor function, mobility, disability, tone anomalies and pusher behaviour were assessed before and after the study period. Immediate effects of a single training session were assessed by clinical observation.


CONCLUSIONS
Immediate effects on the pusher behaviour were observed when using visual and auditory feedback, but not when somatosensory input was used. These results were not maintained to the end of the treatment period. Treatment makes the patient able to use compensatory strategies for functional activities. The long-term effects should be investigated in more depth in the future.
Paci
Matteo
M
Department of Rehabilitation Medicine, Casa di Cura Villa Fiorita, Prato, Italy. matteo.paci@applicazione.it
Nannetti
Luca
L
D000368:Aged; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D004856:Postural Balance; D012678:Sensation Disorders / Q000209:etiology / Q000534:rehabilitation*; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation