Clinical Outcome Measures for Lateropulsion Poststroke: An Updated Systematic Review

Proving once again the incompetence out there in stroke that a review needs to be done at all. There should be a publicly available database of stroke research and protocols updated each time something new comes in. These reviews and meta-analysis are fucking wastes of time getting in the way of actually solving all the problems in stroke.
http://journals.lww.com/jnpt/Abstract/2017/07000/Clinical_Outcome_Measures_for_Lateropulsion.2.aspx

Koter, Ryan PT, DPT; Regan, Sara PT, DPT; Clark, Caitlin PT, DPT; Huang, Vicki DPT; Mosley, Melissa PT, DPT; Wyant, Erin PT, DPT; Cook, Chad PT, PhD, MBA, FAAOMPT; Hoder, Jeffrey PT, DPT, NCS

Journal of Neurologic Physical Therapy: July 2017 - Volume 41 - Issue 3 - p 145–155

doi: 10.1097/NPT.0000000000000194

Systematic Reviews

• Abstract
• Author Information

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, http://links.lww.com/JNPT/A177).

© 2017 Academy of Neurologic Physical Therapy, APTA