title: Effects of galvanic vestibular stimulation combined with physical therapy on pusher behavior in stroke patients: a case series.
abstract: BACKGROUND
  A recent study investigated the effects of galvanic vestibular stimulation (GVS) on pusher behavior (PB) in post-stroke patients. However, there have been no reports about the effects of multisession GVS on PB.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the feasibility and effects of multisession GVS combined with physical therapy for PB in stroke patients.
  
  
  METHODS
  Two stroke patients who showed PB were enrolled. The ABAB single-case design was used. Each phase lasted 1 wk. In phases A1 and A2, the patients underwent a 60-min-long physical therapy session 5 days a week. In phases B1 and B2, they underwent GVS for 20 min before each physical therapy session, and then the same physical therapy program as in phases A1 and A2 were performed. PB was evaluated using the Scale for Contraversive Pushing (SCP) and the Burke Lateropulsion Scale (BLS). Outcomes were tested at the baseline and after each phase.
  
  
  RESULTS
  In both patients, the SCP scores were reduced only during phase B2. Although the BLS scores improved at the A1 phase, a larger improvement was seen at the two B phases.
  
  
  CONCLUSIONS
  Multisession GVS combined with physical therapy may have positive effects on PB in clinical setting.
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Nakamura
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Yorihiro
authors.initials: Y
authors.lastname: Kita
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Yuda
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Ikuno
authors.affiliation: Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Okada
authors.affiliation: Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Shomoto
mesh_terms: D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D026741:Physical Therapy Modalities; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014725:Vestibular Nerve; D014722:Vestibule, Labyrinth
keywords: Pusher behavior; electrical stimulation; galvanic vestibular stimulation; posture control; rehabilitation; stroke