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Lateropulsion After Stroke: Prevalence, Predictors And Impact On Recovery In Subacute Rehabilitation – A Prospective Observational Study
Pavithra Venugopal1*, Narayanasamy Krishnasamy2, Harihara Sudan Subramanian3, Manoj Abraham Manoharlal4
1*Associate Professor, KG College of Physiotherapy (Affiliated to The Tamil Nadu Dr. M.G.R Medical University),
Coimbatore,641035, Tamil Nadu, India.
2 Vice Chancellor, The Tamil Nadu Dr. M.G.R Medical University, Chennai, 600032, Tamil Nadu, India.
3 Professor, KG College of Physiotherapy (Affiliated to The Tamil Nadu Dr. M.G.R Medical University), Coimbatore,641035,
Tamil Nadu, India.
4 Professor/ Principal, KG College of Physiotherapy (Affiliated to The Tamil Nadu Dr. M.G.R Medical University),
Coimbatore,641035, Tamil Nadu, India.
*Corresponding author:
Mrs. Pavithra Venugopal, MPT (Neuro)., MBA.,
Associate Professor
E-mail: pavipvthr93@gmail.com
Phone no: +91 9600969884
ABSTRACT
Background:
Lateropulsion, also known as contraversive pushing, is a common post-stroke disorder that disrupts vertical
orientation and significantly interferes with functional recovery. Its prevalence in subacute rehabilitation settings varies widely,
and the clinical factors predicting its occurrence and its influence on rehabilitation outcomes remain incompletely defined.
Objectives:
To determine the prevalence of lateropulsion in patients undergoing subacute stroke rehabilitation, identify clinical
predictors associated with its presence, and evaluate its impact on functional recovery.
Methods: A prospective observational study was conducted in an Institution and Rehabilitation centre from South India.
Consecutive stroke patients meeting eligibility criteria were enrolled. Demographic data, stroke characteristics, and neurological
assessments were recorded. Lateropulsion was evaluated using the Burke Lateropulsion Scale (BLS). Functional outcomes were
assessed using standardized measures such as the Berg Balance Scale (BBS) and Functional Independence Measure (FIM).
Prevalence was calculated, and predictors were analyzed using appropriate statistical models.
Results:
A total of 176 subacute stroke rehabilitation patients were assessed to determine the prevalence and clinical impact of
lateropulsion. The cohort was predominantly older adults, with most between 40 and 90 years, and females formed 53.41% of
the sample. Ischemic stroke was the major subtype (76.70%), and left-sided involvement slightly predominated (56.25%).
Lateropulsion was present in 34.09% of patients and was more frequent among those aged ≥70 years. Within the lateropulsion
group, ischemic strokes (75%), left-sided lesions (58.33%), and severe NIHSS scores (68.33%) were common, and spatial neglect
was highly prevalent (76.67%). Co-morbidities such as diabetes and heart disease were frequent. Although mean age and NIHSS
values were comparable between groups, individuals with lateropulsion showed significantly poorer functional performance,
reflected by lower BLS (10.56 ± 3.37), BBS (25.72 ± 9.27) and FIM (68.7 ± 14.2) scores compared to those without lateropulsion.
Conclusion:
Overall, the findings indicate that lateropulsion affects one-third of the rehabilitation population and is strongly
associated with older age, neglect, greater stroke severity, and reduced functional balance.
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