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Pusher Syndrome Symptoms, Causes, Physiotherapy, Treatment

Pusher syndrome is an abnormal body posture or postural disorientation. It is a post stroke condition in which patient lies or push towards hemiplegic side of brain with no compensation for instability. Patient is not independent in doing routine activities and require long time for that. In simple words patient tries to push towards the weak side of body. Mostly left side of body is involved as a result of lesion in right hemisphere. Patient with pusher syndrome is at high risk of falling due to imbalance in body. Mostly this syndrome is seen with right hemisphere of brain and less with diseases like multiple sclerosis and brain tumors.


Pusher Syndrome Symptoms

     
Pusher syndrome is characterized as postural disorientation or abnormal body posture. Patient’s body weight is shifted to hemiplegic side and tries to compensate posture imbalance. Patient can fall on one side due to abnormal body posture. Lesion occurs on one side of brain and patient body is pushed to the other side e.g. if lesion is in right hemisphere of brain then patient tends to push towards left side of body. Other symptoms involve spacial neglect and somatic cells sensory impairment. Aphasia, tactile extinction and hypoesthesia is also seen in patients with pusher syndrome.

Pusher Syndrome Symptoms, Causes, Physiotherapy, Treatment

Pusher Syndrome Causes

     
Pusher syndrome occur due to nerve damage. Truncal graviceptive system is responsible for body’s upright position and when nerves of this system got damaged or disturbed after stroke it leads to abnormal posture of body. It occurs due to excessive disruption in somesthetic information processing. Disruption in sensory nerves lead patient to push towards other side of body having no cerebral lesion. Body pushing can be a secondary response to accidental or unexpected experience of loss of body balance. Nerve damage can also occur due to inappropriate oxygen supply or an accidental head injury which leads to abnormal posture.


Pusher Syndrome Physiotherapy

         
Physiotherapy is a treatment option in which body exercises are involved. Main aim of physiotherapy is to increase base support and decrease anxiety as well as improving stability of body. Patient is asked to lay down and relax, then some exercises are performed. Some visual aids are used to make patient oriented towards exercise and learn new moves. Weight lifting exercises are also performed to improve sensory functioning. Weight is allowed to hold on side not working well and movement is observed with continuous exercise.

Pusher Syndrome Treatment


Physiotherapy is the treatment option in which some exercises are performed along with massage to improve sensory nerves. Weight bearing exercises are also performed to compensate abnormal posture. In addition to physiotherapy, there are some additional exercises which improve body posture. Sit stand is an easiest exercise to start with. Patient should try to stand in front of mirror and then start exercising. This will make patient energetic and also help patient as a visual aid. In sit stand, patient have to sit on affected side and then stand reaching in the center. Tactile cueing on hips and quads also help to maintain posture.
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