A clinical roadmap for lateropulsion after stroke based on a realist review strategy
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Objective To generate a clinical roadmap for managing lateropulsion after supratentorial stroke which integrates theory and practice using a realist review strategy. Data Sources Medline Complete, CINAHL Complete, PEDro, Academic Search Complete, Health and Psychosocial Instruments, Health Source: Nursing/Academic Edition, and Embase were searched until December 2025. Review Methods Two searches included review and non-review articles about people with contralesional lateropulsion after supratentorial stroke. We excluded articles about people with ipsilesional lateropulsion resulting from brainstem or cerebellar stroke and non-English articles. Guided by Realist and Meta-narrative Evidence Syntheses: Evolving Standards , pairs of authors independently screened titles and abstracts, determining final lists by consensus. Pairs of authors independently extracted data, ranked levels of evidence, and collaborated to synthesise findings following the context-mechanism-outcome configuration of realist reviews. All authors used this foundation to generate the Lateropulsion Clinical Roadmap and clinical recommendations. Results The review article search yielded four systematic reviews and one scoping review (of 19 screened). The non-review article search yielded 39 articles (of 167 screened), categorised as neuroimaging, epidemiology, assessment and intervention. Clinical recommendations and a Lateropulsion Clinical Roadmap integrated this information. Conclusion A Lateropulsion Clinical Roadmap integrated theory with neuroimaging, epidemiology, assessment and interventions based upon a realist review. Thorough assessment of severity of lateropulsion and neurological impairments should guide clinical decisions about how to leverage sensorimotor systems while considering task difficulty and environment during interventions for lateropulsion. A new hypothesis linking patient presentation with interventions directed at improving sensorimotor performance of the paretic extremities requires further study.
Source: Clinical Rehabilitation
Institutions: City University of New York, Burke Rehabilitation Hospital, New York Medical College, Curtin University, Sir Charles Gairdner Osborne Park Health Care Group, The University of Western Australia, Universidade de São Paulo, Schön Klinik Bad Aibling, Ludwig-Maximilians-Universität München, Weill Cornell Medical Center
Language: English
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W7129521556