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Article Dans Une Revue Clinical Rehabilitation Année : 2023

Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel

Jessica Nolan
Angela Jacques
  • Fonction : Auteur
Erin Godecke
  • Fonction : Auteur
Hiroaki Abe
Suzanne Babyar
  • Fonction : Auteur
Jeannine Bergmann
  • Fonction : Auteur
Melissa Birnbaum
Shenhao Dai
  • Fonction : Auteur
Cynthia Danells
  • Fonction : Auteur
Taiza Gs Edwards
Marialuisa Gandolfi
  • Fonction : Auteur
Klaus Jahn
  • Fonction : Auteur
Ryan Koter
  • Fonction : Auteur
Avril Mansfield
Junji Nakamura
  • Fonction : Auteur
Vicky Pardo
  • Fonction : Auteur
David Punt
  • Fonction : Auteur
Devra Romick-Sheldon
  • Fonction : Auteur
Wim Saeys
  • Fonction : Auteur
Nicola Smania
  • Fonction : Auteur
Nathalie Vaes
  • Fonction : Auteur
Abigail Whitt
Barbara Singer
  • Fonction : Auteur

Résumé

Objective People exhibiting post-stroke lateropulsion actively push their body across the midline to the more affected side and/or resist weight shift toward the less affected side. Despite its prevalence and associated negative rehabilitation outcomes, no clinical practice guidelines exist for the rehabilitation of post-stroke lateropulsion. We aimed to develop consensus-based clinical practice recommendations for managing post-stroke lateropulsion using an international expert panel. Design This Delphi panel process conformed with Guidance on Conducting and Reporting Delphi Studies recommendations. Participants Panel members had demonstrated clinical and/or scientific background in the rehabilitation of people with post-stroke lateropulsion. Main Measures The process consisted of four electronic survey rounds. Round One consisted of 13 open questions. Subsequent rounds ascertained levels of agreement with statements derived from Round One. Consensus was defined a priori as ≥75% agreement (agree or strongly agree), or ≥70% agreement after excluding ‘unsure’ responses. Results Twenty participants completed all four rounds. Consensus was achieved regarding a total of 119 recommendations for rehabilitation approaches and considerations for rehabilitation delivery, positioning, managing fear of falling and fatigue, optimal therapy dose, and discharge planning. Statements for which ‘some agreement’ (50%–74% agreement) was achieved and those for which recommendations remain to be clarified were recorded. Conclusions These recommendations build on existing evidence to guide the selection of interventions for post-stroke lateropulsion. Future research is required to elaborate specific rehabilitation strategies, consider the impact of additional cognitive and perceptual impairments, describe positioning options, and detail optimal therapy dose for people with lateropulsion.

Dates et versions

hal-04207863 , version 1 (14-09-2023)

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Jessica Nolan, Angela Jacques, Erin Godecke, Hiroaki Abe, Suzanne Babyar, et al.. Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel. Clinical Rehabilitation, 2023, 37 (11), pp.1559-1574. ⟨10.1177/02692155231172012⟩. ⟨hal-04207863⟩
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