Publication:

Effectiveness of vestibular rehabilitation among post-stroke pusher syndrome

Background Pusher syndrome is a post-stroke neurobehavioral disorder characterized by a distorted perception of upright posture and active pushing toward the hemiparetic side, leading to impaired balance, increased fall risk, and delayed rehabilitation.

Methods This randomized clinical trial included 36 post-stroke patients diagnosed with pusher syndrome. Participants were randomly assigned to two groups for an 8-week intervention, conducted twice weekly with two sessions per day. Group A received vestibular rehabilitation therapy (VRT) focusing on gaze stabilization, dynamic balance, and proprioceptive training. Group B performed trunk and core stability exercises. Outcome measures included the scale for contraversive pushing (SCP) and postural assessment scale for stroke patients (PASS), assessed pre- and post-intervention.

Results Both groups demonstrated significant improvement; however, group A showed a greater reduction in SCP scores (6.09±0.19 to 2.89±0.17, p<0.001) and a greater increase in PASS scores (11.6±1.1 to 25.8±1.0, p<0.001) compared to group B. Between-group analysis confirmed that VRT was significantly more effective in reducing contraversive pushing and improving postural control.

Conclusions VRT is more effective than trunk stability exercises in improving postural alignment, reducing contraversive pushing, and enhancing functional independence in post-stroke pusher syndrome. Incorporating vestibular strategies into stroke rehabilitation may optimize recovery.