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Atypical balance responses following stroke : a study of patients known as 'pushers'

Atypical balance responses following stroke : a study of patients known as 'pushers'
Atypical balance responses following stroke : a study of patients known as 'pushers'

The aim of this investigation was to add to the knowledge base of balance control post-stroke, by testing for the existence of 'Pushers' and exploring possible causes of their behaviour.

Through a survey, 'Pushers' were found to be atypical but their behaviour was observed more frequency than previously assumed. Two types of 'Pushers' were identified, those with transient abnormal behaviour and those with persistent abnormalities. The pattern of deficits of 'Pushers' were distinguishable from the rest of the sample. In general they suffered more severe impairment than non-sufferers. Must but not all 'Pushers' in the study suffered unilateral neglect.

Cerebral scans highlighted a trend in the lesion sites of subjects in the sample. Lesions covering temporoparietal lobes were identified in more than half of persistent 'Pushers' but temporal lobe damage was not found among 'Non-pushers' or transient 'Pushers'. Vestibular testing was piloted on three subjects; the 'Pusher' had an abnormal response while the two 'Non-pushers' responded normally. The findings of temporal lobe damage and vestibular abnormally among 'Pushers' were interesting but not conclusive or generalisable. If these findings are sustained in further studies they could suggest 'Pushers' suffer an imbalance in the processing of sensory input from the vestibular system.

In conclusion, a sample of patients with acute stroke was divided into two groups according to clinically defined physical behaviour and motor, sensory and perceptual deficits. Initial exploratory findings suggest that an imbalance in vestibular stimuli may contribute to the behaviour of those known as 'Pushers'. Further work is needed to clarify these conclusions.

University of Southampton
Ashburn, Ann Margaret
4c46b8a1-c27f-4aa2-afad-1b1e268530f7
Ashburn, Ann Margaret
4c46b8a1-c27f-4aa2-afad-1b1e268530f7

Ashburn, Ann Margaret (1996) Atypical balance responses following stroke : a study of patients known as 'pushers'. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

The aim of this investigation was to add to the knowledge base of balance control post-stroke, by testing for the existence of 'Pushers' and exploring possible causes of their behaviour.

Through a survey, 'Pushers' were found to be atypical but their behaviour was observed more frequency than previously assumed. Two types of 'Pushers' were identified, those with transient abnormal behaviour and those with persistent abnormalities. The pattern of deficits of 'Pushers' were distinguishable from the rest of the sample. In general they suffered more severe impairment than non-sufferers. Must but not all 'Pushers' in the study suffered unilateral neglect.

Cerebral scans highlighted a trend in the lesion sites of subjects in the sample. Lesions covering temporoparietal lobes were identified in more than half of persistent 'Pushers' but temporal lobe damage was not found among 'Non-pushers' or transient 'Pushers'. Vestibular testing was piloted on three subjects; the 'Pusher' had an abnormal response while the two 'Non-pushers' responded normally. The findings of temporal lobe damage and vestibular abnormally among 'Pushers' were interesting but not conclusive or generalisable. If these findings are sustained in further studies they could suggest 'Pushers' suffer an imbalance in the processing of sensory input from the vestibular system.

In conclusion, a sample of patients with acute stroke was divided into two groups according to clinically defined physical behaviour and motor, sensory and perceptual deficits. Initial exploratory findings suggest that an imbalance in vestibular stimuli may contribute to the behaviour of those known as 'Pushers'. Further work is needed to clarify these conclusions.

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Published date: 1996

Identifiers

Local EPrints ID: 460137
URI: http://eprints.soton.ac.uk/id/eprint/460137
PURE UUID: ec28c050-f737-4cc5-922f-f1805d92d88d

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Date deposited: 04 Jul 2022 18:00
Last modified: 16 Mar 2024 18:36

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Contributors

Author: Ann Margaret Ashburn

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