Clinical Outcome Measures for Lateropulsion Poststroke: An Updated Systematic Review.

Journal Article (Journal Article;Review;Systematic Review)

BACKGROUND AND PURPOSE: Contraversive Lateropulsion, also referred to as contraversive pushing, pusher behavior, and pusher syndrome, can be associated with increased hospital length of stay, increased health care costs, and delayed outcomes in persons with stroke. The purpose of this updated systematic review was to identify scales used to classify contraversive lateropulsion, investigate literature that addresses their clinimetric properties, and create a resource for clinicians recommending use in clinical practice. METHODS: Three databases were searched for articles from inception to March 2017. The search strategy followed Cochrane Collaboration guidelines. The Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was applied to evaluate methodological quality. RESULTS: Four hundred three records were screened. Seven studies met inclusion criteria. Four scales were identified: the Scale for Contraversive Pushing (SCP), the Modified Scale for Contraversive Pushing (M-SCP), the Burke Lateropulsion Scale (BLS), and the Swedish Scale for Contraversive Pushing (S-SCP). Psychometric property investigation was most robust for the SCP and the BLS. Cross-cultural validity has not been fully investigated in scales used outside of their country of origin. DISCUSSION AND CONCLUSIONS: The BLS is recommended for identifying contraversive lateropulsion. The scale assesses the presence of contraversive lateropulsion across several functional tasks, from rolling to walking, and is the only scale originally written in English. The BLS is the only tool to receive ratings greater than poor for reliability and responsiveness. The BLS should be implemented as soon as contraversive lateropulsion is suspected to guide frontline clinicians' initial plan of care, allow objective identification of change over time, and facilitate easier investigation of interventional efficacy.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1,

Full Text

Duke Authors

Cited Authors

  • Koter, R; Regan, S; Clark, C; Huang, V; Mosley, M; Wyant, E; Cook, C; Hoder, J

Published Date

  • July 2017

Published In

Volume / Issue

  • 41 / 3

Start / End Page

  • 145 - 155

PubMed ID

  • 28628548

Electronic International Standard Serial Number (EISSN)

  • 1557-0584

Digital Object Identifier (DOI)

  • 10.1097/NPT.0000000000000194


  • eng

Conference Location

  • United States