Effectiveness of Balance Exercise Program for Stroke Patients With Pusher Syndrome

The Scale for Contraversive Pushing (SCP) allows to diagnose and quantify the pushing behavior of the post-stroke patient. This scale is based on the three main signs of pusher behavior:

• Symmetry of the spontaneous posture,
• Push of the upper or lower non-affected limb towards the affected side,
• Resistance to a passive correction of posture,

Assigning up to 1 point in each subscale and in each position. The maximum score is 6, this being the maximum expression of the pusher behavior.

The Burke Lateropulsion Scale (BLS) is a complementary scale appropriate to the "Contraversive Pushing" scale in the follow-up of patients with pusher behavior in relation to the resistance to passive correction shown by the patient in supine, turning, sitting, standing, walking and transfers scoring up to 17 points.

The scale evaluates the patient in sitting and standing position. The patient will be tilted 30º to the affected side and will be asked to return to the vertical position, according to the degrees where resistance appears will be given a score (0 there is no resistance, 1 resistance that begins at 5º, 2 the resistance begins at 10º, 3 the resistance begins above 10º) and the examiner will score if it is (0-null,1-light, 2-moderate, 3-severe) and the same will be evaluated when standing.

Interobserver reliability has been shown to be effective for therapy.

The S-PASS scale has been validated for post-stroke patients in Spanish. It consists of 12 items and is subdivided into two: mobility (7 items) and balance (5 items). The total score of the scale is 36 points and the score goes from 0 to 3 on each item. The scale also quantifies the help the patient needs to perform each action.

In items 1 to 4 and 8, control of the trunk is evaluated, both on the affected side and on the non-affected side. Items 5 to 7 report anticipatory postural adjustments, in transfers. Items 9 and 10 assess the balance in standing with and without help, respectively, and finally, on items 11 and 12, the one-leg support in affected and not affected leg without help.

The Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) assesses quality of life in patients suffering from ischemic or hemorrhagic stroke.

The questionnaire consists of 56 items distributed in 11 domains: mobility, activities of daily living, pain, vision, cognition, communication, feelings, interpersonal relationships, emotions, sleep and fatigue. In each item the commentary 'due to stroke' is added to differentiate the specific impact of the stroke from other health or social problems, or from natural aging process.

Each item is scored on 4 points (0 to 3). The domain scores are obtained by adding the results of the items included in that domain and then adding each domain to achieve a final score. Higher scores indicate a greater impact on the quality of life of the individual.

The time is difficult to calculate according to the patient's condition can range between 30 and 45 minutes

Measured by the Barthel Index. The Barthel index is a questionnaire with 10 items that assesses the independence of the development of basic activities of daily life (eating, washing, dressing, arranging, evacuating, urinating, going to the toilet, mobile chair, walking and climbing and going down stairs) . The score ranges from 0-100, total dependence, Maximum independence. More specifically, the results are classified as follows: <20 total dependence, 21-60 severe dependence, 61-90 moderate dependence, 91-99 slight dependence, 100 independence.