The association between contraversive lateropulsion and outcomes post stroke: A systematic review

ABSTRACT

Background

Contraversive lateropulsion is a common post-stroke impairment. Rehabilitation outcomes in stroke survivors exhibiting lateropulsion may differ from those without lateropulsion.

Objectives

To systematically review evidence regarding associations between:

1. Presence/severity of lateropulsion after stroke and functional outcome, rehabilitation length of stay, and discharge destination;

2. Stroke-related factors and resolution of lateropulsion, functional outcome, rehabilitation length of stay, and discharge destination in affected stroke survivors.

Methods

Medline, CINAHL, and Embase databases were searched. Journal articles published in English reporting on resolution of lateropulsion, length of stay, functional outcome, and/or discharge destination associated with post-stroke lateropulsion were included for review. Studies that did not include a comparison group (stroke survivors without lateropulsion, or sub-groups of participants with lateropulsion based on stroke-related factors), animal studies, and studies reporting only on ipsiversive lateropulsion and/or lateral medullary syndrome were excluded. Two authors independently assessed studies for inclusion. Included studies were evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies.

Results

Screening identified 133 articles. Seven articles met inclusion criteria. People with contraversive lateropulsion after stroke can achieve similar improvements in function as those without lateropulsion, increasing likelihood of discharge home, but require longer rehabilitation durations to do so.

Conclusions

The finding that longer rehabilitation durations are required for people with post-stroke lateropulsion to achieve their functional potential and increase likelihood of discharge home has implications for resourcing rehabilitation services. Given an additional three to four weeks in rehabilitation, people with post-stroke lateropulsion can achieve functional improvements similar to those without lateropulsion

KEYWORDS:

• LaterOpulsion
• Pusher Syndrome
• Stroke
• Rehabilitation
• Recovery

Supplementary materials

Supplemental data for this article can be accessed on the publisher’s website

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Charlies Foundation for Research [grant number RAC2019-20-019] and the Australian Government Research Training Program Scholarship.