Neuropsychological perspectives on 'Pusher syndrome'

Pusher syndrome (PS) is a term used by many physiotherapists for a collection of symptoms following stroke. An improved understanding of PS may help in assessment and rehabilitation. In this paper a theoretical link is made between neglect and PS. It is suggested that in the assessment of a patient showing PS, assessment for motor and visual neglect should be routine. One therapy for neglect involves increased arousal of the impaired hemisphere via stimulation or motor activation of the contralesional limb or neck muscles. This approach to therapy may improve performance in patients with PS. A questionnaire was sent to 10 hospitals. The results showed that there is a wide variety in definitions between therapists. It is suggested that in the assessment of a patient showing PS, assessment for motor and visual neglect should be routine.