Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature.
OBJECTIVE
To examine the clinimetric properties and clinical applicability of published tools for 'quantifying' the degree of lateropulsion or pusher syndrome following stroke.


METHODS
Search through electronic databases (MEDLINE, EMBASE, CINAHL, Science Citation Index) with the terms lateropulsion, pushing, pusher syndrome, validity, reliability, internal consistency, responsiveness, sensitivity, specificity, posture and stroke. Databases were searched from their inception to October 2008.


METHODS
Abstracts were selected by one author. A panel of experts then determined which should be included in this review. Five abstracts were reviewed and the panel agreed to omit one abstract because those authors did not write a full manuscript. The panel critiqued manuscripts according to predetermined criteria about clinical and clinimetric properties.


RESULTS
Four manuscripts referencing three tools for examining lateropulsion were found. Validity and reliability data support the clinical use of the Scale for Contraversive Pushing, the Modified Scale for Contraversive Pushing and the Burke Lateropulsion Scale. The Scale for Contraversive Pushing has the most extensive testing of clinimetric properties. The other tools show promising preliminary evidence of clinical and research utility. More testing is needed with larger, more diverse samples.


CONCLUSIONS
The Scale for Contraversive Pushing, the Modified Scale for Contraversive Pushing and the Burke Lateropulsion Scale are reliable and valid measures with good clinical applicability. Larger, more varied samples should be used to better delineate responsiveness and other clinimetric properties of these examination tools.
Babyar
Suzanne R
SR
Physical Therapy Program, Hunter College and Graduate Center of the City University of New York and Burke Rehabilitation Hospital, 785 Mamaroneck Avenue, White Plains, New York 10605, USA. sbabyar@burke.org
Peterson
Margaret G E
MG
Bohannon
Richard
R
Pérennou
Dominic
D
Reding
Michael
M
D016206:Databases, Bibliographic; D003943:Diagnostic Techniques, Neurological / Q000295:instrumentation*; D006801:Humans; D009949:Orientation / Q000502:physiology; D004856:Postural Balance / Q000502:physiology; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013577:Syndrome; D054928:Validation Studies as Topic