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geomosley
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| Joined: | Mon Jan 12th, 2009 |
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Posted: Thu Mar 5th, 2009 03:47 pm |
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I would suggest looking at the articles written by Karnath. He has a really good article on the treatment of pushing in the Physical Therapy journal:
Karnath, H and Broetz, D. Understanding and Treating “Pusher Syndrome.” Phys Ther, 2003;83: 1119-1125.
I like to use the Litegait as well for pushers. Another activity I've found helpful is walking overground with the patient turned outward from the actuators. With the directional casters unlocked I ask them to track a straight line down the hall. Initially they will veer into the wall until they figure out how to shift weight to the strong side.
Geoff
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dorischong
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| Joined: | Sat Jun 14th, 2008 |
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Posted: Tue Mar 3rd, 2009 06:43 am |
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Is it the McCain paper you're referring to? I believe it's for stroke patients in general but not necessarily patients with pusher syndrome. I do like to use BWST in pusher patients, especially those who have some strength but it's really the perception that is the issue.
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Jan Harting
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Posted: Tue Mar 3rd, 2009 06:19 am |
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These are some of my favorite patients to use the LiteGait with. Lately I have been reading that it is beneficial to start with gait training using the LiteGait over the treadmill even prior to overground ambulation to promote as normal a movement pattern as possible.
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Lesley Smith
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| Joined: | Wed Aug 29th, 2007 |
| Location: | Humarock, MA |
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Posted: Wed Aug 20th, 2008 12:28 am |
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Thanks Doris - I'll take a look at it.
Lesley
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dorischong
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Posted: Thu Aug 7th, 2008 06:31 am |
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Lesley,
I wrote an article for Advance PT megazine two years ago sharing my strategies on treating patients with pusher syndrome, and last year on the use of LiteGait on a pusher syndrome patient. My strategies of treating pusher syndrome has always been using a sturdy wall on patient's strong side and use visual feedback (mirror) to provide a sense of security. Initial treatment focuses on weight shifting to the strong side using task oriented approach. I've also tried using the LiteGait on these patients and found great success. I usually have patients to line themselves up with the actuator while they're on the treadmill. These patients love the body weight support because they're free from falling, and often times it's not because they can't move but because they will push themselves until they fall that limits the mobility. Having their weight supported takes away this fear, and using tightening the straps on the affected side helps to minimize the lean.
Hope it helps!
Doris
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Lesley Smith
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Posted: Fri Oct 26th, 2007 01:40 am |
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I'd like to revisit the topic of Contraversive Pushing (AKA Pusher Syyndrome). Does anyone have any treatment suggestions or success stories to share?
Thanks,
Lesley
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