Relationship of white matter lesions and severity of pushing behavior after stroke.
Yuji Fujino, Kazu Amimoto, Satoshi Sugimoto and 5 others
PMID 29643587WHAT IT FOUND
In acute stroke patients with pushing behavior, daily living improvement did not differ by stroke type or white matter lesions.
Total anterior circulation strokes had worse pushing, trunk control, and impairment than partial anterior circulation strokes.
Key findings
01Barthel efficiency scores were not significantly different across the four groups.
02Patients with total anterior circulation infarcts had higher Scale for Contraversive Pushing scores and lower Trunk Control Test scores than patients with partial anterior circulation infarcts without white matter lesions.
03Patients with total anterior circulation infarcts had lower Stroke Impairment Assessment Set scores than patients with partial anterior circulation infarcts.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 37 patients with pushing behavior were analysed, and the four groups were very small, with one group containing 5 patients. The study looked only at short-term changes in functional outcome, so it cannot show long-term recovery. Statistical power was low for some outcomes, especially Barthel efficiency, so a real difference could have been missed. All patients received standard physiotherapy, occupational therapy, neuropsychological therapy, speech therapy, and nursing care together, so the study cannot identify which component affected outcomes. The study was retrospective and used an existing database, so allocation and treatment were not controlled by the researchers. White matter lesions were judged on the unaffected side and grouped as present or absent using a visual scale, so small differences in lesion burden may not be captured.
The easy way to misread this
Do not conclude that white matter lesions cause worse pushing or slower daily living recovery. The Barthel efficiency result did not show a difference, the sample was small, and all patients received standard physiotherapy, occupational therapy, neuropsychological therapy, speech therapy, and nursing care together, so no single component or lesion type can be separated as the cause.