Physiotherapeutic aspects and prognostic of Pusher Syndrome

DOI: 10.15343/0104-7809.200832.2.12

Abstract

Pusher Syndrome (PS) is an alteration of postural control characterized by a disorder of vertical body perception relative to gravity,
in which patients push the body laterally using the non-paretic hemibody. It has not been much studied and there are still controversies in the
literature regarding therapeutic and prognostic aspects. The aim of this work was checking these therapeutic and prognostic factors. For doing
that, a literature survey was done by means of simple inquiries in the bases Medline, Embase, Pubmed, Lilacs, EBM, Cochrane, Peter, Scielo, Portal
da Pesquisa and Informa World, with the keywords pusher syndrome, contraversive pushing and pusher behavior. Clinical papers were included
with therapeutic and / or prognostic approach in all languages. Clinical papers were excluded with etiologic, physiopathologic and diagnostic
approaches. Altogether, 341 references were found and 8 clinical papers were found that filled the inclusion criteria. Only 2 studies described
the used therapeutic methodology, which consisted in visual feedback on the correct vertical posture, since vertical visual perception seems to
persist but transfer of weight and march training were skills absent in these patients, who move the body laterally. Apparently, the syndrome
has a good prognostic, with reduced or absent symptoms from 2 to 6 months after the beginning of rehabilitation. The associated presence of
heminegligence and the etiology of injury seem to compromise prognostic. This therapeutic strategy had satisfactory results, but more randomized
studies are necessary to prove its efficiency and impact on Pusher Syndrome prognostic.