Concurrent therapy and vestibular stimulation for Pusher syndrome
Research type
Research Study
Full title
Combining physical therapy with vestibular stimulation to improve postural stability in Pusher's syndrome: a pilot study
IRAS ID
222784
Contact name
Diego Kaski
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Pusher syndrome (PS) is a disorder of postural control and orientation which causes brain-lesioned patients to perceive subjective upright verticality when in fact they are positioned towards their hemiparetic (paralysed) side. PS is a common disorder and can affect 16% of stroke patients (Baccini et al, 2008). Barra et al (2010) proposed that pushing is a result of neglect of truncal somatosensory information which is a necessary component in the formulation of internal representation of subjective upright verticality.
We hypothesise that GVS in combination with focussed physiotherapy treatment will lead to an improvement in functional ability (measured by the FIM and BERG balance scale), pushing behaviour (as measured by the Scale of Contraversive Pushing and The Burke Lateropulsion Scale) and neglect (measured by the Bergago neglect battery, Mesulam’s symbol cancellation test and line dissection test).
16 patients will be recruited with PS from the Regional Neurological Rehabilitation Unit at Homerton Hospital. We will record subjective visual vertical, subjective postural vertical and subjective haptic vertical. The number of patients has been identified as a realistic number of patients presenting with PS on these wards within the time frame of the pilot study. The intervention group of 8 patients will receive GVS and standard Physiotherapy treatment for PS. The control group of 8 patients will receive only standard Physiotherapy treatment for PS. 16 healthy aged-matched healthy volunteers will also be recruited from the Homerton hospital therapies department and tested.
Primary outcome measures for pushing, (Scale of Contraversive Pushing and The Burke Lateropulsion Scale), neglect (Bergago neglect battery, Mesulam’s symbol cancellation test and line dissection test) and function (Berg Balance Scale and Functional Impairment Measure) will be recorded. Outcome measures will be taken at baseline, post initial treatment session, end of week one and end of week two, and data analysed at CX Hosp.
REC name
Wales REC 6
REC reference
17/WA/0097
Date of REC Opinion
28 Apr 2017
REC opinion
Further Information Favourable Opinion