Influence of hydrotherapy on trunk control in the pusher syndrome: case report

Abstract

Pusher, or lateropulsion, syndrome is a clinical disorder following brain damage in which patients actively push away from the nonhemiparetic side, leading to a loss of postural balance. This study analysed the effect of hydrotherapy on trunk alignment in a 78 year-old male patient with the syndrome. Pusher syndrome was diagnosed by means of the scale for contraversive pushing. Trunk symmetry was assessed by photogrammetry: head, shoulder and trunk alignment angles were measured on photographs taken before and after treatment. Aquatic therapy consisted in two weekly one-hour sessions for two months (total 16 sessions), using the Bad Ragaz and the Halliwick techniques, with the purpose of strengthening upper limb and trunk muscles, respectively. The post-treatment assessment showed an important reduction in tilt angles of head (from 31.7º to 10.6º), shoulders (from 10.3º to 1.7º), and trunk alignment (from 9.6º to 3.0º). The hydrotherapy program proposed thus showed beneficial in assuring the patient with pusher syndrome better trunk symmetry and alignment.