NPTE Practice Questions: Pusher's Syndrome

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Looking to pass the NPTE?
We've got you covered. In this video, we discuss one of the more difficult topics on the NPTE: pusher's syndrome. We'll go over a scenario including Pusher's syndrome and how to handle it!
In this video we'll go over one of my best mock-NPTE practice questions so that you can pass the exam on your first try or your next attempt! Check out PT Hustle's website at www.pthustle.com for more awesome content like this!
How well do you know Pusher's Syndrome? Let's test your understanding in this excellent episode about one of the hardest types of neuro questions.
NPTE Practice Question:
Ben presents with Pusher's Syndrome and anosognosia after a recent posterolateral thalamic stroke. The patient is undergoing gait training activities with an emphasis on safety. Which of the following interventions is the MOST appropriate?
Answer Choices:
A. Standing on the uninvolved side and cueing the patient to, "lean towards me"
B. Lowering the cane height on the uninvolved side
C. Place the cane in the involved hand and encourage weight-bearing through the affected side
D. Standing on the involved side and pushing the patient away
Do you think you know which answer is correct? Watch the video to find out.
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Disclaimer: The PT Hustle along with the contents of this video including the question and rationale are not affiliated with the National Physical Therapy Examination® (NPTE) or property of Federation of State Boards of Physical Therapy® (FSBPT). The information contained in this video should not be taken as medical advice. The information provided in this training should not be used as the sole source of clinical, legal, or medical advice. Please use sound clinical judgment based upon the best evidence when treating yourself or a patient.
Music credit: The Future Bass by Starjammusic

Пікірлер: 13

@emilygoeken9072 4 жыл бұрын

My difficultly with this question is that Neurological Rehabilitation, Neuroscience and Neuroplasticity in Physical Therapy Practice by Nichols-Larsen, states multiple times to guard on the non-paretic side. When your on the paretic side guarding, your body would be pushing the patient back toward the non-paretic side, which would encourage the patient to push more toward that paretic side. When guarding on the non-paretic side, you can use your body weight to counteract the pushing and instead be "pulling" if a LOB or fall were to occur. Verbal cuing to lean back toward me would also be a way to counteract the pushing to the paretic side. I also see how B is correct because pushers often have tendency to push backwards, which by lowering the cane you would be also be encouraging somewhat of a forward lean (which raises concerns with safety and proper body mechanics?) but, you would also be encouraging a more upright position in regards to the frontal plane.

@ThePTHustle 4 жыл бұрын

Hey Emily! Definitely agree with you here and I believe that we just have to be careful with the idea of context. You don't want to ever leave the weak side unguarded. If there is another therapist, bed, wall or something to catch the patient on the weak side then yes you can guard the strong side with a gait belt. But in the text you reference, it doesn't explicitly state to guard the non-paretic side when there is nothing to protect the patient on the side of weakness. The ideal situation would be to guard them on the strong side (like you stated) but making sure there is something protecting the weak side (i.e., wall or bed or associate). When working with these patients, if you stand on the strong side, you can pull them towards you with gait belt yes... ...but often times their affected leg will give out and they will go to the ground. Hence the reason for the support on the weak side. Being on the weak side you can block the knee from buckling.

@kylerice7312 4 жыл бұрын

Also, Emily I forgot to address your other thoughts. When guarding on the weak side, the therapist shouldn't be "pushing" the patient back to midline. You are right that's not appropriate. Instead the goal is for you to truly "guard" against falling and cue the patient to lean over towards the wall on the strong side. There may be an object or even something the patient needs to reach for on the strong side as well. That becomes the cue, not pushing them. As far as the lowering the cane thought... this is correct as well. I got your point that body mechanics will be stressed but sometimes we need to sacrifice certain aspects in order to ensure patient safety while retraining their neurological system.

@MedaPeutics 2 жыл бұрын

I agree with you--but I can not see how B is correct because nothing in the question even references an AD nor does it indicate inappropriate height of an AD---so its pulling the answer from thin air. I agree with your neuro reasoning for sure