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Seminar Detail

How to Successfully Treat Stroke Patients with Pusher Syndrome: The Ultimate Guide to Safer, More Predictable Recovery

Friday, March 6, 2020 at 8:00 AM - 4:00 PM

This event is not currently available for purchase.

For more information: Call (800) 844-8260
Course Description:

Pushing behavior presents serious challenges during stroke rehabilitation. Patients who push are often low level, need a lot of assistance, have considerable safety concerns, and do not respond to typical treatment interventions. This seminar will show you how to address the root causes of pusher syndrome.

This lab-intensive, 6-hour seminar will show you how to address the root causes of pusher syndrome with evidence-based treatment activities and progressions. Learn how to assess and address the limiting impairments of pusher patients, utilizing the ICF model and principles of neuroplasticity to select the right intervention at the right time, and to maximize treatment outcomes. Additionally, appropriate assessment tools and functional performance tests will be practiced in order to apply treatment ideas in any environment. You will come away with techniques applicable to other patients who present with similar impairments such as difficulty with midline, retropulsion, trunk malalignments, postural control deficits, and gait dysfunction, making this course a great investment! This dynamic course will take your treatments to the next level!

  1. Discuss current literature regarding suggested pathology of “pusher syndrome”.
  2. Recognize and list common characteristics and functional presentation of a patient who “pushes”.
  3. Develop a skill set for understanding normal movements as well as executing task analysis for assessments of impairments limitations.
  4. Discuss the criteria critical in categorizing the “pusher” patient as a low, mid, or high-level “pusher.”
  5. Identify appropriate treatment interventions for the low, mid, and high-level “pusher” patient to specifically improve noted activity limitations.
  6. Practice supporting and positioning techniques that enhance safely for the clinician and patient.
  7. Strategize progressions of interventions to reduce impairments and lessen activity limitations to maximize participation for each patient with “pusher syndrome”.

  • Case Study
  • ICF Models guide to clinical reasoning
  • Levels of ICF definitions and examples
  • Correlation with assessment, prognosis and treatment planning
  • Role of vestibular system
  • Localization of lesions correlating with “pushing”
  • Thalamic lesions and “pushing”
  • Role of graviceptive systems
  • Best support for occurrence of “pushing”
  • Alignment faults (trunk, head, pelvis, femur)
  • Movement dysfunction
  • Midline deficits
  • Other (sensory loss, visual, neglect, cognition)
  • Hands-On Lab
  • Tests to confirm presence of “Pushing”
  • Outcome measures
  • Role of upper and lower trunk assessment
  • Hands-On Lab
  • Why use this framework for clinical reasoning
  • What is the framework
  • How it guides tasks assessment and guides treatment choice
  • How to execute a task analysis
  • Neuroplasticity and directing treatment choices
  • Motor control and motor learning theories on set-up and progression
  • Choosing a position for treatment
  • Align patient for best results
  • Activate muscles in coordinated sequenced fashion to mimic functional demands
  • Rehabilitation of function
  • Compensation or Recovery?
  • Hands-On Lab
  • Primary characteristic for each level
  • Starting point and progression
  • Functional re-education considerations
  • Use of objects, adjunct, and equipment in treatment
Target Audience

  • Physical Therapists
  • Physical Therapy Assistants
  • Occupational Therapists
  • Occupational Therapy Assistants
  • Exercise Physiologists
What You Should Bring
  • Piece of resistance band (light to moderate resistance), at least 2 feet long
  • A standard size hand towel or bath towel


Michelle Green, PT, DPT, C-NDT, NCS, is an expert in stroke rehabilitation, with over 20 years of experience helping countless patients recover from neurological conditions. Her background in NDT, Pilates, and yoga has influenced her assessment and treatment approach, providing her with enhanced insight into movement assessment and guided movement re-education.

Dr. Green travels nationally to present seminars on stroke rehabilitation, and she is known for her dynamic, hands-on teaching style. She earned her Doctorate in Physical Therapy from University of North Carolina Chapel Hill, and she teaches as an assistant professor in the DPT program at Campbell University. Her additional interests include education and learning, impairment-based treatment across the lifespan, and application of mind-body practices for improving mental and physical health.

Speaker Disclosures:

Financial: Michelle Green is an assistant professor at Campbell University She receives a speaking honorarium from PESI, Inc.

Non-financial: Michelle Green is a member of the American Physical Therapy Association; and the North Carolina Physical Therapy Association.
Credits listed below are for full attendance at the live event only. After attendance has been verified, pre-registered attendees will receive an email from PESI Customer Service with the subject line, “Evaluation and Certificate” within one week. This email will contain a link to complete the seminar evaluation and allow attendees to print, email or download a certificate of completion if in full attendance. For those in partial attendance (arrived late or left early), a letter of attendance is available through that link and an adjusted certificate of completion reflecting partial credit will be issued within 30 days (if your board allows). Please see “live seminar schedule” for full attendance start and end times. NOTE: Boards do not allow credit for breaks or lunch.

If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, or questions on home study credit availability, please contact or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

The planning committee and staff who controlled the content of this activity have no relevant financial relationships to disclose. For speaker disclosures, please see speaker bios.

PESI, Inc. offers continuing education programs and products under the brand names PESI, PESI Healthcare, PESI Rehab and Psychotherapy Networker.

Exercise Physiologists
ASEP members will earn 5.0 CECs for full attendance at this seminar. The ASEP allows members to earn a maximum of 10 CECs in any one 5 year period.

Nurses, Nurse Practitioners, and Clinical Nurse Specialists
American Nurses Credentialing Center Logo
PESI, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Nurses in full attendance will earn 6.3 contact hours. Partial contact hours will be awarded for partial attendance.

Occupational Therapists & Occupational Therapy Assistants
PESI, Inc. is an AOTA Approved Provider of continuing education. Provider #: 3322. Full attendance at this course qualifies for 6.0 contact hours or .6 CEUs in the Category of Domain of OT and Occupational Therapy Process. Partial credit will be issued for partial attendance. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate.

Physical Therapists & Physical Therapist Assistants
This activity consists of 6.25 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary per state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

New Jersey Physical Therapists & Physical Therapist Assistants: This course has been approved by the New Jersey Board of Physical Therapy Examiners for 6.25 credits. Board Course Number: 1911-171.

New York Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This course qualifies for 7.6 Contact Hours.

Pennsylvania Physical Therapists & Physical Therapist Assistants: The Pennsylvania State Board of Physical Therapy recognizes approval by all other state boards. This activity consists of 6.25 clock hours of instruction that is applicable for physical therapists.

Other Professions
This activity qualifies for 380 minutes of instructional content as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific requirements.

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