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Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel.

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Title: Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel.
Authors: Nolan, Jessica, Jacques, Angela, Godecke, Erin, Abe, Hiroaki, Babyar, Suzanne, Bergmann, Jeannine, Birnbaum, Melissa, Dai, Shenhao, Danells, Cynthia, Edwards, Taiza GS, Gandolfi, Marialuisa, Jahn, Klaus, Koter, Ryan, Mansfield, Avril, Nakamura, Junji, Pardo, Vicky, Perennou, Dominic, Piscicelli, Celine, Punt, David, Romick-Sheldon, Devra
Source: Clinical Rehabilitation. Nov2023, Vol. 37 Issue 11, p1559-1574. 16p.
Subjects: Perceptual disorders, Medical personnel, Quantitative research, Medical protocols, Surveys, Stroke rehabilitation, Expertise, Descriptive statistics, Research funding, Hemiparesis, Thematic analysis, Delphi method
Abstract: Objective: People exhibiting post-stroke lateropulsion actively push their body across the midline to the more affected side and/or resist weight shift toward the less affected side. Despite its prevalence and associated negative rehabilitation outcomes, no clinical practice guidelines exist for the rehabilitation of post-stroke lateropulsion. We aimed to develop consensus-based clinical practice recommendations for managing post-stroke lateropulsion using an international expert panel. Design: This Delphi panel process conformed with Guidance on Conducting and Reporting Delphi Studies recommendations. Participants: Panel members had demonstrated clinical and/or scientific background in the rehabilitation of people with post-stroke lateropulsion. Main Measures: The process consisted of four electronic survey rounds. Round One consisted of 13 open questions. Subsequent rounds ascertained levels of agreement with statements derived from Round One. Consensus was defined a priori as ≥75% agreement (agree or strongly agree), or ≥70% agreement after excluding 'unsure' responses. Results: Twenty participants completed all four rounds. Consensus was achieved regarding a total of 119 recommendations for rehabilitation approaches and considerations for rehabilitation delivery, positioning, managing fear of falling and fatigue, optimal therapy dose, and discharge planning. Statements for which 'some agreement' (50%–74% agreement) was achieved and those for which recommendations remain to be clarified were recorded. Conclusions: These recommendations build on existing evidence to guide the selection of interventions for post-stroke lateropulsion. Future research is required to elaborate specific rehabilitation strategies, consider the impact of additional cognitive and perceptual impairments, describe positioning options, and detail optimal therapy dose for people with lateropulsion. [ABSTRACT FROM AUTHOR]
Copyright of Clinical Rehabilitation is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel.
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  Data: <searchLink fieldCode="JN" term="%22Clinical+Rehabilitation%22">Clinical Rehabilitation</searchLink>. Nov2023, Vol. 37 Issue 11, p1559-1574. 16p.
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  Data: <searchLink fieldCode="DE" term="%22Perceptual+disorders%22">Perceptual disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+personnel%22">Medical personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Quantitative+research%22">Quantitative research</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+protocols%22">Medical protocols</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke+rehabilitation%22">Stroke rehabilitation</searchLink><br /><searchLink fieldCode="DE" term="%22Expertise%22">Expertise</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Hemiparesis%22">Hemiparesis</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Delphi+method%22">Delphi method</searchLink>
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  Label: Abstract
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  Data: Objective: People exhibiting post-stroke lateropulsion actively push their body across the midline to the more affected side and/or resist weight shift toward the less affected side. Despite its prevalence and associated negative rehabilitation outcomes, no clinical practice guidelines exist for the rehabilitation of post-stroke lateropulsion. We aimed to develop consensus-based clinical practice recommendations for managing post-stroke lateropulsion using an international expert panel. Design: This Delphi panel process conformed with Guidance on Conducting and Reporting Delphi Studies recommendations. Participants: Panel members had demonstrated clinical and/or scientific background in the rehabilitation of people with post-stroke lateropulsion. Main Measures: The process consisted of four electronic survey rounds. Round One consisted of 13 open questions. Subsequent rounds ascertained levels of agreement with statements derived from Round One. Consensus was defined a priori as ≥75% agreement (agree or strongly agree), or ≥70% agreement after excluding 'unsure' responses. Results: Twenty participants completed all four rounds. Consensus was achieved regarding a total of 119 recommendations for rehabilitation approaches and considerations for rehabilitation delivery, positioning, managing fear of falling and fatigue, optimal therapy dose, and discharge planning. Statements for which 'some agreement' (50%–74% agreement) was achieved and those for which recommendations remain to be clarified were recorded. Conclusions: These recommendations build on existing evidence to guide the selection of interventions for post-stroke lateropulsion. Future research is required to elaborate specific rehabilitation strategies, consider the impact of additional cognitive and perceptual impairments, describe positioning options, and detail optimal therapy dose for people with lateropulsion. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Clinical Rehabilitation is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1177/02692155231172012
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        Text: English
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