[Effects of massage in critically ill patients with pusher syndrome : Randomized controlled mixed-methods study protocol].

Abstract

Background: A complication of stroke is the pusher syndrome (PS). PS results in an altered verticality perception and in a reduced clinical outcome. Effective interventions in the treatment of PS, feasible in nursing care, are lacking to date.

Aim: Examining whether neurophysiological massage has effects on the perception of verticality (primary outcome) and whether effects on the severity of PS can be proved (secondary outcome).

Method: Participants of this multicentered, randomized controlled trial will be recruited in the setting of acute and rehabilitation hospitals. The participants of the intervention group will receive once a day, on eight consecutive days a neurophysiological massage, while the control group will receive usual care including training for selfcare and clothing skills as well as mobilization into the wheelchair. The primary outcome will be evaluated in the sitting position, immediately after conducting the intervention, after 10 minutes, and 3 days after the intervention period ends by measuring the shank deviation angle compared to the body midline. The secondary outcome will be evaluated before starting and after ending the intervention period as well as 3 days after the intervention period ends by using the scale of contraversive pushing (SCP). Furthermore, problem-centered interviews will be conducted pre- and post-interventionally and analyzed using the Witzel method.

Expected results: The hypothesis of whether neurophysiological massage could improve the perception of verticality in patients affected by PS more than usual care will be examined. The study could show an effect of neurophysiological massage on the perception of the subjective postural vertical. Conducting interviews will allow a holistic understanding of PS.