I am a 6th year DPT student doing a clinical in in-patient rehab right now. We have three patients right now that exhibit severe pushing to their affected side while ambulating. Does anyone have treatment ideas we can try?
Here are a few strategies that work for pts with Pusher's Syndrome:
1.) Orient the pt to vertical using a door frame, holding your arm in front of them or use edge of a mirror. Research shows that it is the impaired perception of vertical that is causing the presentation. Explain to the pt what is happening and how to correct it using the proper cues and assistance to correct.
2.) To eliminate pushing with the UE, have the pt place his/her hands palms up on the lap after their posture is corrected
3.) To decrease pushing with the LE, bring the leg out further forward (increase knee ext). This will make it more difficult for the pt to push with the legs during dynamic sitting balance activities.
4.) A standing activity could be using the uninvolved UE to assist the involved side in reaching activity on a high mat that can support the arms if needed.