Fisioterapia e Pesquisa
Print version ISSN 1809-2950
VOOS, Mariana Callil; OLIVEIRA, Tatiana de Paula and PIEMONTE, Maria Elisa Pimentel. Guidelines for assessment and physical therapy treatment in Pusher´s Syndrome: case report. Fisioter. Pesqui. [online]. 2011, vol.18, n.4, pp. 323-328. ISSN 1809-2950. http://dx.doi.org/10.1590/S1809-29502011000400005.
The Pusher´s Syndrome (PS) is a perceptual disorder that occurs in 10% of the cases of hemiparesis caused by stroke. It is characterized by falling to the paretic side, pushing to the paretic side with the non-paretic side and resisting to external correction. The present study aimed to describe the assessment, treatment and clinical evolution of a patient with left paresis and PS, caused by a stroke on the right hemisphere. Six months after the lesion, the patient was submitted to perceptual (human figure drawing test, behavioral inattention test, scale for contraversive pushing, minimental state examination) and functional performance tests (postural assessment stroke scale, Jebsen-Taylor hand function test, functional independence measure and Barthel index) and started physical therapy twice a week. Each session consisted of 3 parts of 20 minutes: sensory stimulation, motor training and sensory-motor integration. After six months, the patient showed improvement in all scales. The scale for contraversive pushing and the Jebsen-Taylor hand function test showed the highest percentages of improvement, 79% and 46%, respectively. Besides having been started six months after the lesion, the protocol of the present study contributed to the improvement of perception and functional performance. These findings suggest the importance of the physical therapy treatment in the recovery of individuals with PS.
Keywords : perceptual disorders; physical therapy; postural balance.