LAUSR

Objective Recent researches suggested that postural disorders after stroke may be partly caused by a wrong referential of verticality, expressed by a lateropulsion behavior. The role played by lateropulsion in the postural and gait disorders after stroke remained to be investigated, which was the objective of the present study. Material/patients and methods Retrospective cohort study (2012–2017) of 147 consecutive patients investigated in a neurorehabilitation ward in average at 32.7 days after a first hemispheric stroke: age 62.8 ± 12.6 years, 41 females, 120 with infarction, 57 with right lesion. Trained physiotherapists assessed: lateropulsion with the Scale for Contraversive Pushing (SCP, 0–6), Balance disorders with the Postural Assessment Scale for Stroke (PASS, 0–36), and gait disorders with Lindmark Scale (0–6). Brain imaging were carefully checked (138 MRI, 9 CT). Patients with a malignant stroke, dementia, instable medical status that could interfere with balance and gait recovery, or those who refused the assessments were not included. Descriptive data are given in the form median (first-third quartile). Results One month post-stroke, postural and gait data were: SCP 0 (0–0.25), PASS 32 (25–35) and Gait score 4 (2–6). Fifteen patients were pushers (10%), among them 80% had a right hemisphere stroke. A first result was to confirm that lateropulsion was more severe in right hemisphere stroke than in left (right 46% vs. left 10%, ×2 = 47.7; P  Discussion – conclusion Lateropulsion, which is a sign of biased representation of the vertical, is a primary cause of postural and gait disorders at the subacute phase after right hemisphere stroke, explaining almost 80% of balance and gait disabilities. A greater attention should be focused on the assessment and the rehabilitation of the post-stroke lateropulsion.