Lateropulsion: A Common but Understood Stroke Complication
Lateropulsion, a clinical condition characterized by the body leaning to one side, affects approximately 50% of stroke survivors. Despite its prevalence, lateropulsion is still severely under-recognized and under-assessed globally.
Individuals with lateropulsion rely on the limbs on their stronger side to push themselves towards their weaker side. Often, they resist correction back towards their stronger side or the midline, resulting in difficulties with sitting, standing, walking, and self-care. Additionally, lateropulsion is associated with an increased risk of falls, reduced recovery, and decreased likelihood of discharge after inpatient rehabilitation.
The Importance of Understanding Lateropulsion
Dr. Jessica Nolan, a PhD graduate from Edith Cowan University, emphasizes the crucial role of understanding and addressing lateropulsion in stroke survivors. Its treatment is a critical aspect of rehabilitation, yet it requires better understanding and more research.
In 2020 alone, Australia saw approximately 39,500 stroke events, averaging over 100 per day. More than 445,087 Australians were estimated to be living with the effects of stroke in the same year. Stroke remains one of Australia’s leading causes of death, surpassing breast cancer for women and prostate cancer for men.
Challenges in Addressing Lateropulsion
Despite the prevalence of lateropulsion following stroke, a lack of consistent terminology and defining features hinders understanding its prevalence, accurately comparing research results, and agreeing on a uniform approach to rehabilitation.
Progress Towards Better Understanding and Treatment
Dr. Nolan has led a Delphi consensus process, collaborating with international experts to reach a consensus on terminology and rehabilitation needs for individuals with severe lateropulsion, as well as rehabilitation recommendations. While a consensus on terminology was not achieved, the panel agreed that lateropulsion was the preferred term.
Furthermore, over 100 consensus-based recommendations were developed to guide lateropulsion rehabilitation.
Dr. Nolan’s most recent research indicates that lateropulsion can continue to resolve up to one year post-stroke, extending beyond the period of inpatient rehabilitation. The average length of inpatient stay for stroke patients varies, but those with lateropulsion experience stays approximately three to four weeks longer compared to those without.
Implications for Rehabilitation
This study underscores the importance of access to ongoing rehabilitation to facilitate lateropulsion resolution. Individuals without access to long-term rehabilitation following stroke do not exhibit the same extent of lateropulsion resolution or functional recovery.
Conclusion
Lateropulsion is a common complication of stroke that requires greater recognition and understanding. By addressing the challenges in terminology, assessment, and treatment, healthcare professionals can improve rehabilitation outcomes and enhance the quality of life for stroke survivors.
