Zusammenhang zwischen neurophysiologischer Ausstreichung und posturaler Vertikaler bei Schlaganfallbetroffenen mit dem Pusher Syndrom - NAPV –

Abstract

Relation between a neurophysiological body-expunction and the postural vertical of stroke affected patients suffering from the pusher syndrome Background: The pusher syndrome is a severe complication of stroke. This syndrome hampers the perception of verticality and induces a physical instability for the patients suffering from this disease pattern. These patients are thereby affected by a fear of falling. Yet a lack of effective interventions feasible for nursing practice is detectable. Aim: The aim of this study is to evaluate whether the pusher behaviour can be reduced by a body-expunction. Furthermore, the NAPV-study is to investigate whether a potential effect persists over a specific time course. Methods: The NAPV-study is based upon a quasi-experimental study-design. The pusher syndrome in the study participants is ascertained by the scale of contraversive pushing (SCP) and a measurement of the shank deviation in relation to the trunk axis. Subsequently a body-expunction is conducted successively in a ten-day period. After every single body-expunction, the subjective postural vertical of the patients is evaluated by measuring the shank deviation in an upright and in a trunk tilted position at three given times. Concluding the intervention period, another SCP assessment follows. The data analysis is conducted by Friedman test and by Wilcoxon signed-rank test. Results: The Wilcoxon test (z = -2,943, p = 0,001) as well as the Friedman test (Chi2 (10) > 36,45; p = 0,001) show a significant reduction of pusher behaviour. Conclusions: The findings suggest that a body-expunction can reduce the pusher behaviour and is feasible for nursing practice.