Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen stroke study
Objectives: A “pusher syndrome” encompassing postural imbalance and hemineglect is believed to aggravate the prognosis of stroke patients. Our aim was to determine the incidence, associated neuropsychological symptoms, and the consequences for rehabilitation of ipsilateral pushing. Design: Consecuti...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 1996, Vol.77 (1), p.25-28 |
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| creator | Pedersen, Palle M. Wandel, Anette Jørgensen, Henrik S. Nakayama, Hirofumi O. Raaschou, Hans S. Olsen, Tom |
| description | Objectives: A “pusher syndrome” encompassing postural imbalance and hemineglect is believed to aggravate the prognosis of stroke patients. Our aim was to determine the incidence, associated neuropsychological symptoms, and the consequences for rehabilitation of ipsilateral pushing.
Design: Consecutive and community-based.
Setting: A stroke unit receiving all acute stroke patients from a well-defined catchment area. All stages of rehabilitation were completed within the unit.
Patients: 647 acute stroke patients admitted during a 1-year period. Excluded were 320 patients who did not receive physiotherapy because they did not have pareses of the leg, had a fast remission, or died.
Main Outcome Measures: Gain in activities of daily living (ADL) function (Barthel Index), time course of functional remission, and discharge rate to nursing home. The independent impact of ipsilateral pushing was analyzed with multiple linear and logistic regression analyses.
Results: Ipsilateral pushing was found in 10% of the included patients. No significant differences were found in the incidence of hemineglect and anosognosia between patients with and without ipsilateral pushing. No association with side of stroke lesion was found. Ipsilateral pushing had no independent influence on gain in ADL function or discharge rate to nursing home, but patients with ipsilateral pushing used 3.6 weeks (
P < .0001) more to reach the same final outcome level than did patients without ipsilateral pushing.
Conclusions: The existence of a “pusher syndrome” was not confirmed. Ipsilateral pushing did not affect functional outcome, but showed the process of recovery considerably. |
| doi_str_mv | 10.1016/S0003-9993(96)90215-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_77987566</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0003999396902154</els_id><sourcerecordid>77987566</sourcerecordid><originalsourceid>FETCH-LOGICAL-c507t-30256206a2476cdd065a7618cb4a4ed0a822b6b2c71a179cd1b743f6a584afb83</originalsourceid><addsrcrecordid>eNqFkV2L1DAUhoMo67j6ExZyIaKwXZO0SRtvZBn8GFjwwhW8C2lyOo22TTdJhfkP-6PNfDi3Xh3Ced5zTt4XoStKbiih4v13QkhZSCnLt1K8k4RRXlRP0IrykhUNoz-fotUZeY5exPgrPwUv6QW6aDivKiFX6HEzRzfoBEEPeF5i76YtdhOOKfjf8AFvJuMsTAaucYDMOT_h5PEES_Bz3JneD37rTBbH3TgnP8ZrrCeL3Thrk3CmA_S6dYNLB_ENvu8Br_0MU6-38G9RLovdvUTPOj1EeHWql-jH50_366_F3bcvm_XtXWE4qVNREsYFI0KzqhbG2vwpXQvamLbSFViiG8Za0TJTU01raSxt66rshOZNpbu2KS_Rm-PcOfiHBWJSo4sGhkFP4Jeo6lo2NRcig_wImuBjDNCpObhRh52iRO1TUIcU1N5iJYU6pKCqrLs6LVjaEexZdbI991-f-jpm77qgs83xjDHZcMn2Yz4eMchm_HEQVDRuH4Z1AUxS1rv_HPIXtWWmuw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>77987566</pqid></control><display><type>article</type><title>Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen stroke study</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Pedersen, Palle M. ; Wandel, Anette ; Jørgensen, Henrik S. ; Nakayama, Hirofumi ; O. Raaschou, Hans ; S. Olsen, Tom</creator><creatorcontrib>Pedersen, Palle M. ; Wandel, Anette ; Jørgensen, Henrik S. ; Nakayama, Hirofumi ; O. Raaschou, Hans ; S. Olsen, Tom</creatorcontrib><description>Objectives: A “pusher syndrome” encompassing postural imbalance and hemineglect is believed to aggravate the prognosis of stroke patients. Our aim was to determine the incidence, associated neuropsychological symptoms, and the consequences for rehabilitation of ipsilateral pushing.
Design: Consecutive and community-based.
Setting: A stroke unit receiving all acute stroke patients from a well-defined catchment area. All stages of rehabilitation were completed within the unit.
Patients: 647 acute stroke patients admitted during a 1-year period. Excluded were 320 patients who did not receive physiotherapy because they did not have pareses of the leg, had a fast remission, or died.
Main Outcome Measures: Gain in activities of daily living (ADL) function (Barthel Index), time course of functional remission, and discharge rate to nursing home. The independent impact of ipsilateral pushing was analyzed with multiple linear and logistic regression analyses.
Results: Ipsilateral pushing was found in 10% of the included patients. No significant differences were found in the incidence of hemineglect and anosognosia between patients with and without ipsilateral pushing. No association with side of stroke lesion was found. Ipsilateral pushing had no independent influence on gain in ADL function or discharge rate to nursing home, but patients with ipsilateral pushing used 3.6 weeks (
P < .0001) more to reach the same final outcome level than did patients without ipsilateral pushing.
Conclusions: The existence of a “pusher syndrome” was not confirmed. Ipsilateral pushing did not affect functional outcome, but showed the process of recovery considerably.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/S0003-9993(96)90215-4</identifier><identifier>PMID: 8554469</identifier><identifier>CODEN: APMHAI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cerebrovascular Disorders - complications ; Cerebrovascular Disorders - diagnosis ; Cerebrovascular Disorders - rehabilitation ; Female ; Humans ; Incidence ; Length of Stay ; Male ; Medical sciences ; Neostriatum - diagnostic imaging ; Neurology ; Neuropsychological Tests ; Postural Balance - physiology ; Posture - physiology ; Prognosis ; Psychomotor Disorders - diagnosis ; Psychomotor Disorders - epidemiology ; Psychomotor Disorders - etiology ; Psychomotor Disorders - rehabilitation ; Radiography ; Regression Analysis ; Sensation Disorders - etiology ; Sensation Disorders - rehabilitation ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Archives of physical medicine and rehabilitation, 1996, Vol.77 (1), p.25-28</ispartof><rights>1996</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-30256206a2476cdd065a7618cb4a4ed0a822b6b2c71a179cd1b743f6a584afb83</citedby><cites>FETCH-LOGICAL-c507t-30256206a2476cdd065a7618cb4a4ed0a822b6b2c71a179cd1b743f6a584afb83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0003-9993(96)90215-4$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,4025,27927,27928,27929,45999</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2985924$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8554469$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pedersen, Palle M.</creatorcontrib><creatorcontrib>Wandel, Anette</creatorcontrib><creatorcontrib>Jørgensen, Henrik S.</creatorcontrib><creatorcontrib>Nakayama, Hirofumi</creatorcontrib><creatorcontrib>O. Raaschou, Hans</creatorcontrib><creatorcontrib>S. Olsen, Tom</creatorcontrib><title>Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen stroke study</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Objectives: A “pusher syndrome” encompassing postural imbalance and hemineglect is believed to aggravate the prognosis of stroke patients. Our aim was to determine the incidence, associated neuropsychological symptoms, and the consequences for rehabilitation of ipsilateral pushing.
Design: Consecutive and community-based.
Setting: A stroke unit receiving all acute stroke patients from a well-defined catchment area. All stages of rehabilitation were completed within the unit.
Patients: 647 acute stroke patients admitted during a 1-year period. Excluded were 320 patients who did not receive physiotherapy because they did not have pareses of the leg, had a fast remission, or died.
Main Outcome Measures: Gain in activities of daily living (ADL) function (Barthel Index), time course of functional remission, and discharge rate to nursing home. The independent impact of ipsilateral pushing was analyzed with multiple linear and logistic regression analyses.
Results: Ipsilateral pushing was found in 10% of the included patients. No significant differences were found in the incidence of hemineglect and anosognosia between patients with and without ipsilateral pushing. No association with side of stroke lesion was found. Ipsilateral pushing had no independent influence on gain in ADL function or discharge rate to nursing home, but patients with ipsilateral pushing used 3.6 weeks (
P < .0001) more to reach the same final outcome level than did patients without ipsilateral pushing.
Conclusions: The existence of a “pusher syndrome” was not confirmed. Ipsilateral pushing did not affect functional outcome, but showed the process of recovery considerably.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cerebrovascular Disorders - complications</subject><subject>Cerebrovascular Disorders - diagnosis</subject><subject>Cerebrovascular Disorders - rehabilitation</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neostriatum - diagnostic imaging</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Postural Balance - physiology</subject><subject>Posture - physiology</subject><subject>Prognosis</subject><subject>Psychomotor Disorders - diagnosis</subject><subject>Psychomotor Disorders - epidemiology</subject><subject>Psychomotor Disorders - etiology</subject><subject>Psychomotor Disorders - rehabilitation</subject><subject>Radiography</subject><subject>Regression Analysis</subject><subject>Sensation Disorders - etiology</subject><subject>Sensation Disorders - rehabilitation</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV2L1DAUhoMo67j6ExZyIaKwXZO0SRtvZBn8GFjwwhW8C2lyOo22TTdJhfkP-6PNfDi3Xh3Ced5zTt4XoStKbiih4v13QkhZSCnLt1K8k4RRXlRP0IrykhUNoz-fotUZeY5exPgrPwUv6QW6aDivKiFX6HEzRzfoBEEPeF5i76YtdhOOKfjf8AFvJuMsTAaucYDMOT_h5PEES_Bz3JneD37rTBbH3TgnP8ZrrCeL3Thrk3CmA_S6dYNLB_ENvu8Br_0MU6-38G9RLovdvUTPOj1EeHWql-jH50_366_F3bcvm_XtXWE4qVNREsYFI0KzqhbG2vwpXQvamLbSFViiG8Za0TJTU01raSxt66rshOZNpbu2KS_Rm-PcOfiHBWJSo4sGhkFP4Jeo6lo2NRcig_wImuBjDNCpObhRh52iRO1TUIcU1N5iJYU6pKCqrLs6LVjaEexZdbI991-f-jpm77qgs83xjDHZcMn2Yz4eMchm_HEQVDRuH4Z1AUxS1rv_HPIXtWWmuw</recordid><startdate>1996</startdate><enddate>1996</enddate><creator>Pedersen, Palle M.</creator><creator>Wandel, Anette</creator><creator>Jørgensen, Henrik S.</creator><creator>Nakayama, Hirofumi</creator><creator>O. Raaschou, Hans</creator><creator>S. Olsen, Tom</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1996</creationdate><title>Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen stroke study</title><author>Pedersen, Palle M. ; Wandel, Anette ; Jørgensen, Henrik S. ; Nakayama, Hirofumi ; O. Raaschou, Hans ; S. Olsen, Tom</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-30256206a2476cdd065a7618cb4a4ed0a822b6b2c71a179cd1b743f6a584afb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cerebrovascular Disorders - complications</topic><topic>Cerebrovascular Disorders - diagnosis</topic><topic>Cerebrovascular Disorders - rehabilitation</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neostriatum - diagnostic imaging</topic><topic>Neurology</topic><topic>Neuropsychological Tests</topic><topic>Postural Balance - physiology</topic><topic>Posture - physiology</topic><topic>Prognosis</topic><topic>Psychomotor Disorders - diagnosis</topic><topic>Psychomotor Disorders - epidemiology</topic><topic>Psychomotor Disorders - etiology</topic><topic>Psychomotor Disorders - rehabilitation</topic><topic>Radiography</topic><topic>Regression Analysis</topic><topic>Sensation Disorders - etiology</topic><topic>Sensation Disorders - rehabilitation</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pedersen, Palle M.</creatorcontrib><creatorcontrib>Wandel, Anette</creatorcontrib><creatorcontrib>Jørgensen, Henrik S.</creatorcontrib><creatorcontrib>Nakayama, Hirofumi</creatorcontrib><creatorcontrib>O. Raaschou, Hans</creatorcontrib><creatorcontrib>S. Olsen, Tom</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pedersen, Palle M.</au><au>Wandel, Anette</au><au>Jørgensen, Henrik S.</au><au>Nakayama, Hirofumi</au><au>O. Raaschou, Hans</au><au>S. Olsen, Tom</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen stroke study</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>1996</date><risdate>1996</risdate><volume>77</volume><issue>1</issue><spage>25</spage><epage>28</epage><pages>25-28</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><coden>APMHAI</coden><abstract>Objectives: A “pusher syndrome” encompassing postural imbalance and hemineglect is believed to aggravate the prognosis of stroke patients. Our aim was to determine the incidence, associated neuropsychological symptoms, and the consequences for rehabilitation of ipsilateral pushing.
Design: Consecutive and community-based.
Setting: A stroke unit receiving all acute stroke patients from a well-defined catchment area. All stages of rehabilitation were completed within the unit.
Patients: 647 acute stroke patients admitted during a 1-year period. Excluded were 320 patients who did not receive physiotherapy because they did not have pareses of the leg, had a fast remission, or died.
Main Outcome Measures: Gain in activities of daily living (ADL) function (Barthel Index), time course of functional remission, and discharge rate to nursing home. The independent impact of ipsilateral pushing was analyzed with multiple linear and logistic regression analyses.
Results: Ipsilateral pushing was found in 10% of the included patients. No significant differences were found in the incidence of hemineglect and anosognosia between patients with and without ipsilateral pushing. No association with side of stroke lesion was found. Ipsilateral pushing had no independent influence on gain in ADL function or discharge rate to nursing home, but patients with ipsilateral pushing used 3.6 weeks (
P < .0001) more to reach the same final outcome level than did patients without ipsilateral pushing.
Conclusions: The existence of a “pusher syndrome” was not confirmed. Ipsilateral pushing did not affect functional outcome, but showed the process of recovery considerably.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8554469</pmid><doi>10.1016/S0003-9993(96)90215-4</doi><tpages>4</tpages></addata></record> |
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| ispartof | Archives of physical medicine and rehabilitation, 1996, Vol.77 (1), p.25-28 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals |
| subjects | Activities of Daily Living Aged Aged, 80 and over Biological and medical sciences Cerebrovascular Disorders - complications Cerebrovascular Disorders - diagnosis Cerebrovascular Disorders - rehabilitation Female Humans Incidence Length of Stay Male Medical sciences Neostriatum - diagnostic imaging Neurology Neuropsychological Tests Postural Balance - physiology Posture - physiology Prognosis Psychomotor Disorders - diagnosis Psychomotor Disorders - epidemiology Psychomotor Disorders - etiology Psychomotor Disorders - rehabilitation Radiography Regression Analysis Sensation Disorders - etiology Sensation Disorders - rehabilitation Vascular diseases and vascular malformations of the nervous system |
| title | Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen stroke study |
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