Post-stroke lateropulsion in Australia and New Zealand: a survey investigating current knowledge, priorities and practice

Post-stroke lateropulsion is prevalent and associated with poor rehabilitation outcomes, but evidence to guide rehabilitation of affected stroke survivors is limited. Current post-stroke lateropulsion rehabilitation practice across Australia and New Zealand has not been previously described. This study aimed to describe lateropulsion rehabilitation practice in Australia and New Zealand, determine clinicians,’ educators’ and researchers’ opinions about the need for educational resources to guide best-practice, and to identify current barriers to, and enablers of, optimal rehabilitation delivery. This cross-sectional survey was distributed to stroke rehabilitation clinicians, educators and researchers across Australia and New Zealand using Qualtrics. Data were described using frequency distributions and Chi-squared tests. Responses to open-ended questions were summarized for reporting. The final analyses included 127 surveys. Most participants (93%) were physiotherapists. The importance of identifying and assessing post-stroke lateropulsion was noted by 97.6% of participants; however routine lateropulsion assessment was reported by only 60.6% of respondents. About 93.6% of participants indicated that lateropulsion should be targeted as a rehabilitation priority. Limitations in knowledge and skill among clinicians and insufficient evidence to guide rehabilitation were noted as barriers to best-practice rehabilitation delivery. Most respondents (95.2%) indicated that lateropulsion management should be included in stroke rehabilitation guidelines. A sample of clinicians, educators, and researchers involved in stroke rehabilitation across Australia and New Zealand have indicated that lateropulsion should be targeted as a rehabilitation priority. Knowledge and skill were identified as barriers to best-practice rehabilitation implementation, which could be improved by addressing lateropulsion in clinical practice guidelines.

卒中后偏侧推挤（post-stroke lateropulsion）患病率较高，且与不良康复结局相关，但指导卒中后偏侧推挤患者康复的相关证据仍较为有限。目前，澳大利亚与新西兰地区针对卒中后偏侧推挤的康复实践尚未有过相关报道。
本研究旨在描述澳大利亚与新西兰地区的偏侧推挤康复实践现状，明确临床医师、教育工作者及研究人员对制定优质康复指导教育资源的需求看法，并识别当前影响最优康复方案实施的障碍与促进因素。
本研究采用横断面调查设计，通过Qualtrics平台向澳大利亚及新西兰地区的卒中康复临床医师、教育工作者与研究人员发放问卷。数据采用频数分布及卡方检验进行描述性分析，对开放式问题的回复进行汇总后予以报告。
最终共纳入127份有效问卷。大部分参与者（93%）为物理治疗师。97.6%的参与者认可卒中后偏侧推挤识别与评估的重要性，但仅60.6%的受访者表示会常规开展偏侧推挤评估。约93.6%的参与者认为应将偏侧推挤作为康复优先干预目标。临床医师知识与技能的不足，以及缺乏指导康复实践的有效证据，被认为是阻碍最佳实践康复实施的主要障碍。95.2%的受访者认为应将偏侧推挤管理纳入卒中康复临床实践指南。
本次参与澳大利亚及新西兰地区卒中康复工作的临床医师、教育工作者及研究群体均表示，应将偏侧推挤列为康复优先干预目标；临床医师的知识与技能不足被认定为最佳实践康复实施的障碍，而通过在临床实践指南中纳入偏侧推挤相关内容，可有效改善该现状。