Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study
Ipsilateral pushing in stroke: Incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study
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DOI：
10.1016/s0003-9993(96)90215-4
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发表时间：
1996-01-01
影响因子：
4.3
通讯作者：
Olsen, TS
中科院分区：
文献类型：
--
作者：
Pedersen, PM;Wandel, A;Olsen, TS
目的：一种包括姿势不平衡和偏侧运动在内的“推者综合征”被认为会加重脑卒中患者的预后。我们的目的是确定发病率，相关的神经心理学症状，并为同侧pushing.Design康复的后果：Concreative和社区为基础的。设置：中风单位接收所有急性中风患者从一个明确的集水区。康复的所有阶段都在单位内完成。患者：647例急性中风患者在1年期间入院。排除了320例没有接受物理治疗，因为他们没有pareses的腿，有一个快速缓解，或dead.Main结果测量：增益日常生活活动（ADL）功能（Barthel指数），时间过程中的功能缓解，出院率到疗养院。采用多元线性回归和Logistic回归分析同侧推挤的独立影响。结果：同侧推挤发生率为10%。有无同侧推挤的患者，其偏侧运动障碍和疾病感缺失的发生率无显著差异。同侧推挤对ADL功能的增加或出院率没有独立影响，但同侧推挤的患者比无同侧推挤的患者多用了3.6周（p <0.0001）才达到相同的最终结局水平。结论：“推挤综合征”的存在未得到证实。同侧推挤不影响功能结果，但大大减缓了恢复过程。(C)1996年由美国康复医学大会和美国物理医学与康复学会
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 slowed the process of recovery considerably. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation