#55: El comportamiento empujador post-ictus

En el episodio de hoy, hablo del síndrome del empujador o patrón empujador, característico de algunos pacientes que han sufrido un ictus e incluso otras lesiones cerebrales. También llamado pusher, lateropulsión o empuje contraversivo, es un fenómeno neurológico que caracteriza la postura y el movimiento de algunos pacientes. En el episodio explico las generalidades, neuroanatomía, valoración y estrategias de tratamiento. Referencias del episodio: 1. Karnath HO, Broetz D. Understanding and treating "pusher syndrome". Phys Ther. 2003 (https://pubmed.ncbi.nlm.nih.gov/14640870/). 2. Karnath HO, Johannsen L, Broetz D, Küker W. Posterior thalamic hemorrhage induces "pusher syndrome". Neurology. 2005 (https://pubmed.ncbi.nlm.nih.gov/15781819/). 3. Roller, Margaret L. DPT, MS. The ‘Pusher Syndrome’. Journal of Neurologic Physical Therapy: 2004 (https://journals.lww.com/jnpt/Fulltext/2004/03000/The__Pusher_Syndrome_.4.aspx). 4. Pérennou DA et al. Lateropulsion, pushing and verticality perception in hemisphere stroke: a causal relationship? Brain. 2008 (https://pubmed.ncbi.nlm.nih.gov/18678565/). 5. Bergmann J et al. The Subjective Postural Vertical Determined in Patients with Pusher Behavior During Standing. Top Stroke Rehabil. 2016 (https://pubmed.ncbi.nlm.nih.gov/27077977/). 6. Dai S et al. Balance, Lateropulsion, and Gait Disorders in Subacute Stroke. Neurology. 2021 (https://pubmed.ncbi.nlm.nih.gov/33177223/). 7. Nolan J, Godecke E, Singer B. The association between contraversive lateropulsion and outcomes post stroke: A systematic review. Top Stroke Rehabil. 2022 (https://pubmed.ncbi.nlm.nih.gov/33648434/). 8. Karnath HO, Ferber S, Dichgans J. The origin of contraversive pushing: evidence for a second graviceptive system in humans. Neurology. 2000 (https://pubmed.ncbi.nlm.nih.gov/11087771/). 9. Babyar SR et al. Lesion Localization of Poststroke Lateropulsion. Stroke. 2019 (https://pubmed.ncbi.nlm.nih.gov/31009350/). 10. Lee KB et al. Is Lateropulsion Really Related with a Specific Lesion of the Brain? Brain Sci. 2021 (https://pubmed.ncbi.nlm.nih.gov/33802116/). 11. Rosenzopt et al. Thalamocortical networks involved in Pusher Syndrome. bioRxiv. 2022 (https://www.biorxiv.org/content/10.1101/2022.10.12.511887v1). 12. Babyar SR et al. Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature. Clin Rehabil. 2009 (https://pubmed.ncbi.nlm.nih.gov/19403555/). 13. Bergmann J et al. A new cutoff score for the Burke Lateropulsion Scale improves validity in the classification of pusher behavior in subactue stroke patients. Gait Posture. 2019 (https://pubmed.ncbi.nlm.nih.gov/30623845/). 14. Martín Nieto, Ana (2018) Traducción, adaptación cultural y validación al castellano de las escalas "Scale for contraversive pushing" y "Burke laterospulsion scale". [Tesis] (https://eprints.ucm.es/id/eprint/46327/). 15. Paci M et al. Treatment approaches for pusher behaviour: a scoping review. Top Stroke Rehabil. 2022 (https://pubmed.ncbi.nlm.nih.gov/35156566/). 16. Bergmann J et al. Robot-assisted gait training to reduce pusher behavior: A randomized controlled trial. Neurology. 2018 (https://pubmed.ncbi.nlm.nih.gov/30171076/). 17. Romick-Sheldon D, Kimalat A. Novel Treatment Approach to Contraversive Pushing after Acute Stroke: A Case Report. Physiother Can. 2017 (https://pubmed.ncbi.nlm.nih.gov/30369698/). 18. Pardo V, Galen S. Treatment interventions for pusher syndrome: A case series. NeuroRehabilitation. 2019 (https://pubmed.ncbi.nlm.nih.gov/30814367/).