Week 12

what assessment findings are lateropulsion treatments based on

presence and severity of impairments, functional level, diagnosis, clinical course, contextual factors

observations that indicate lateropulsion

postural lean, limited/no weight transfer to less affected side, excess/uncontrolled movement to the more affected side

compensatory movements of lateropulsion

using less affected arm to hand from a rail/bar, leaning on someone/something on affected side, weight transfer achieved by trunk lean

physiotherapy treatment of lateropulsion

education, exercise based treatment, aids/compensatory strategies, carer training

approach to lateropulsion treatment is informed by

severity, patient’s awareness of lateropulsion, individual factors (age, mobility, additional impairments, goals)

principles of lateropulsion management

recognise altered perception, facilitate weight shift, prioritise tactile cues, reduce less affected side overactivity, encourage active weight shift

strategies for facilitating full weight transfer

active transfer in an easier position first

clear, simple instructions, environment provides clarity and security

sense of security through body contact and handling

ease of movement transitions

alignment for lateropulsion treatment

• Less affected foot inside line of hip

• Weight on less affected ischial tuberosity (lateral tilt)

• Shoulder outside the line of hip

• Reaching laterally and forwards (sit to stand)

• Plinth height; toenails under kneecaps; pelvis forward

which side shoulder the physio be on for severe lateropulsion treatment

less affected side, holding the thorax

which side should the PTA be on for severe lateropulsion treatment

more affected side, holding the hips

why is lateropulsion treatment encouraging full weight transfer, not just midline

required for walking and functional mobility

effect of lateropulsion on outcome

partial or complete resolution is possible, associated with longer rehab in hospital, ongoing resolution possible after discharge