A clinical roadmap for lateropulsion after stroke based on a realist review strategy.
Suzanne Babyar, Nicholas Sheehan, Jessica Nolan and 4 others
PMID 41700998WHAT IT FOUND
Clinicians can use this roadmap to assess lateropulsion, choose interventions by lesion and verticality deficits, and anticipate slower recovery after right hemisphere stroke.
These are expert recommendations, not tested interventions.
Key findings
01The roadmap recommends a formal baseline lateropulsion assessment, using the Burke Lateropulsion Scale with a cut-off score of 2 or above to define lateropulsion.
02Intervention choice should follow verticality deficits: use somatosensory cueing, use visual feedback only when visual vertical is within normal range of ±2.5 degrees, and consider robot-assisted gait training as another suggested option.
03In one randomised controlled trial of 36 participants, 30 minutes of daily robot-assisted gait training for 2 weeks plus standard rehabilitation may produce the same improvement as intensive gait training using a knee-ankle-foot orthosis and physical therapist assistance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only English articles were searched, so non-English evidence may be missing. The roadmap includes case studies and case series, and the authors say more robust research is needed to confirm these findings. Many intervention recommendations rest on low-level evidence, and the authors state that these strategies require further research before routine clinical practice. Realist reviews rely on subjective interpretation, and the authors do not expect prescriptive generalisability. The paper synthesises existing studies rather than testing a treatment, so it cannot show that any intervention works.
Declared interests
The authors received no financial support for the research, authorship, or publication, and declared no potential conflicts of interest.
The easy way to misread this
Do not read the roadmap as proof that robot-assisted gait training, prone positioning, eye covering, or virtual reality treats lateropulsion. The paper is a realist review of mixed evidence, including case studies, and the authors state that these strategies require further research before routine clinical recommendation.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →